Question

A 79-year-old nursing home resident with type 2 diabetes presents with confusion and dehydration. Capillary glucose is 40 mmol/L, serum osmolality markedly elevated and ketones are minimal. Arterial pH is 7.36. What is the BEST description of his condition compared with DKA?

Accepted Answer

He has hyperosmolar hyperglycaemic state characterised by marked hyperglycaemia and hyperosmolality with minimal ketosis

Answer

He has DKA because glucose is elevated

Answer

He has lactic acidosis due to metformin

Answer

He has normal metabolic status and requires no intervention

Answer

He has DKA because ketones are always present in hyperglycaemia

Practice question

A 79-year-old nursing home resident with type 2 diabetes presents with confusion and dehydration. Capillary glucose is 40 mmol/L, serum osmolality markedly elevated and ketones are minimal. Arterial pH is 7.36. What is the BEST description of his condition compared with DKA?