A 78-year-old man with type 2 diabetes is admitted from a care home with confusion and severe dehydration. Capillary glucose is 39 mmol/L, serum osmol...

Question

A 78-year-old man with type 2 diabetes is admitted from a care home with confusion and severe dehydration. Capillary glucose is 39 mmol/L, serum osmolality is 330 mOsm/kg and there is no significant ketonaemia or acidosis. What is the most important immediate treatment priority?

Accepted Answer

Gradual IV rehydration with 0.9% sodium chloride

Answer

Immediate high-dose IV insulin bolus

Answer

High-dose subcutaneous rapid-acting insulin every hour

Answer

Oral Metformin and fluids by mouth

Answer

No acute treatment is required

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

A 78-year-old man with type 2 diabetes is admitted from a care home with confusion and severe dehydration. Capillary glucose is 39 mmol/L, serum osmolality is 330 mOsm/kg and there is no significant ketonaemia or acidosis. What is the most important immediate treatment priority?