A 74-year-old woman with type 2 diabetes is drowsy after 3 days of polyuria and poor intake. Glucose is 46 mmol/L, osmolality 338 mOsm/kg, pH 7.34

Question

A 74-year-old woman with type 2 diabetes is drowsy after 3 days of polyuria and poor intake. Glucose is 46 mmol/L, osmolality 338 mOsm/kg, pH 7.34 and ketones are 0.8 mmol/L. Sodium is 154 mmol/L. What is the most likely diagnosis?

Accepted Answer

Hyperosmolar hyperglycaemic state

Answer

Adrenal crisis

Answer

Lactic acidosis from metformin

Answer

Cerebral venous sinus thrombosis

Answer

Diabetic ketoacidosis

Hyperosmolar hyperglycaemic state — RACP Written MCQ

A 74-year-old woman with type 2 diabetes is drowsy after 3 days of polyuria and poor intake. Glucose is 46 mmol/L, osmolality 338 mOsm/kg, pH 7.34 and ketones are 0.8 mmol/L. Sodium is 154 mmol/L. What is the most likely diagnosis?