T2D with ASCVD — SCE Endocrinology MCQ

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Hard"Endocrinology"T2D with ASCVDSCE Endocrinology

A patient with suspected hyperosmolar hyperglycaemic state has sodium 150 mmol/L, glucose 42 mmol/L and urea 12 mmol/L. Using the JBDS formula, what is the calculated osmolality?

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Correct answer: D — 354 mOsm/kg

JBDS calculated osmolality is 2 × sodium + glucose + urea, with all values in mmol/L. Thus, 2 × 150 + 42 + 12 = 354 mOsm/kg. The rate of osmolality fall, fluid balance and sodium trajectory guide treatment more safely than glucose alone.

Reference: Joint British Diabetes Societies guideline for adult hyperosmolar hyperglycaemic state (Published 2023): https://onlinelibrary.wiley.com/doi/abs/10.1111/dme.15005; NICE NG17 recommendations for type 1 diabetes in adults (Updated 17 August 2022): https://www.nice.org.uk/guidance/ng17/chapter/Recommendations