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

Practice 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?