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HardEndocrinologyHyperosmolar hyperglycaemic stateuk-plab-1

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?

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