A 60-year-old female with type 2 diabetes is found unresponsive at home. Her blood glucose is 42 mmol/L. She has a GCS of 7, respiratory rate of 32, b...

Question

A 60-year-old female with type 2 diabetes is found unresponsive at home. Her blood glucose is 42 mmol/L. She has a GCS of 7, respiratory rate of 32, blood pressure of 90/55 mmHg, and is severely dehydrated with a heart rate of 130 bpm. She has no ketonuria. What is the most likely diagnosis?

Accepted Answer

Hyperosmolar hyperglycaemic state (HHS) - characterised by marked hyperglycaemia, severe dehydration, hyperosmolality, and absent or minimal ketosis

Answer

Urinary tract infection causing sepsis only

Answer

Diabetic ketoacidosis - DKA and HHS are identical conditions

Answer

Simple hyperglycaemia requiring insulin only

Answer

Stroke causing the unconsciousness

uk-dipimc MCQ (SBA): Hyperosmolar Hyperglycaemic State

A 60-year-old female with type 2 diabetes is found unresponsive at home. Her blood glucose is 42 mmol/L. She has a GCS of 7, respiratory rate of 32, blood pressure of 90/55 mmHg, and is severely dehydrated with a heart rate of 130 bpm. She has no ketonuria. What is the most likely diagnosis?