A 79-year-old woman with type 2 diabetes on Metformin is found on ward round to be drowsy and severely dehydrated. Capillary glucose is 38 mmol/L, ser...

Question

A 79-year-old woman with type 2 diabetes on Metformin is found on ward round to be drowsy and severely dehydrated. Capillary glucose is 38 mmol/L, serum osmolality is raised and blood ketones are 0.6 mmol/L. Arterial pH is 7.35. What is the most likely diagnosis?

Accepted Answer

Hyperosmolar hyperglycaemic state

Answer

Diabetic ketoacidosis

Answer

Hypoglycaemia

Answer

Lactic acidosis secondary to Metformin

Answer

Septic shock

uk-plab-1 MCQ (SBA): Hyperosmolar hyperglycaemic state

A 79-year-old woman with type 2 diabetes on Metformin is found on ward round to be drowsy and severely dehydrated. Capillary glucose is 38 mmol/L, serum osmolality is raised and blood ketones are 0.6 mmol/L. Arterial pH is 7.35. What is the most likely diagnosis?