Question

A 72-year-old man with type 2 diabetes is found to have a random plasma glucose of 32 mmol/L, serum osmolality 330 mOsm/kg, pH 7.37 and no significant ketonaemia. He is profoundly dehydrated and confused. What is the most likely diagnosis?

Accepted Answer

Hyperosmolar hyperglycaemic state

Answer

Diabetic ketoacidosis

Answer

Lactic acidosis due to metformin

Answer

Hypoglycaemia

Answer

Normal variation in glucose due to stress

Practice question

A 72-year-old man with type 2 diabetes is found to have a random plasma glucose of 32 mmol/L, serum osmolality 330 mOsm/kg, pH 7.37 and no significant ketonaemia. He is profoundly dehydrated and confused. What is the most likely diagnosis?