Question

An 81-year-old care home resident presents with hyperosmolar hyperglycaemic state (HHS): glucose 40 mmol/L, osmolality high, minimal ketones. What is the key early management priority?

Accepted Answer

Aggressive IV fluid resuscitation and careful monitoring, delay insulin initially

Answer

Immediate insulin bolus and infusion

Answer

Oral metformin

Answer

IV bicarbonate

Answer

Immediate potassium infusion regardless of result

Practice question

An 81-year-old care home resident presents with hyperosmolar hyperglycaemic state (HHS): glucose 40 mmol/L, osmolality high, minimal ketones. What is the key early management priority?