Bart is a patient is a 67-year-old male with T2 DM. He is on glipizide and metformin. He presents to the clinic with confusion, sluggishness, and extreme thirst
His wife tells you Bart does not follow his meal plan or exercise regularly, and hasn't checked his BG for 1 week. A random glucose is drawn and it is 500. What is a likely diagnosis based on preliminary assessment?
1. Diabetic keto acidosis (DKA)
2. Hyperglycemic hyperosmolar syndrome (HHS)
3. Infection
4. Hypoglycemia
ANS: 2
RATIONALE: HHS is the most likely diagnosis based on diagnosis, age, and signs and symptoms. DKA may occur in T2 diabetes, but initially HHS would be suspect.
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