Hyperglycemic hyperosmolar state is most common in which group?

Hyperglycemic hyperosmolar state is most common in which group?

• A. Gestational diabetes.
• B. Type I DM in younger individuals.
• C. Type II DM in older adults.
• D. Type II DM patients over 50 years old.

Answer: (D)

Hyperglycemic hyperosmolar state tends to occur in older adults with type 2 diabetes. In type 2 diabetes there’s usually enough endogenous insulin to prevent significant ketosis and acidosis, even when glucose levels soar. But insulin is often not enough to curb hyperglycemia and the osmotic diuresis that follows, so patients become profoundly dehydrated and develop very high serum osmolality. This combination is classically seen in people over 50 who have type 2 diabetes and may have precipitating factors like infection, poor intake, or dehydration. The result is extreme hyperglycemia with marked hyperosmolarity but little or no ketosis, distinguishing it from diabetic ketoacidosis, which is more common in younger patients with type 1 diabetes.

Hyperglycemic hyperosmolar state tends to occur in older adults with type 2 diabetes. In type 2 diabetes there’s usually enough endogenous insulin to prevent significant ketosis and acidosis, even when glucose levels soar. But insulin is often not enough to curb hyperglycemia and the osmotic diuresis that follows, so patients become profoundly dehydrated and develop very high serum osmolality. This combination is classically seen in people over 50 who have type 2 diabetes and may have precipitating factors like infection, poor intake, or dehydration. The result is extreme hyperglycemia with marked hyperosmolarity but little or no ketosis, distinguishing it from diabetic ketoacidosis, which is more common in younger patients with type 1 diabetes.