Which of the following patients is at the highest risk for hyperosmolar hyperglycemic syndrome?
A) An 18-year-old college student with type 1 diabetes who exercises excessively
B) A 45-year-old woman with type 1 diabetes who forgets to take her insulin in the morning
C) A 75-year-old man with type 2 diabetes and coronary artery disease who has recently started on insulin injections
D) An 83-year-old, long-term care resident with type 2 diabetes and advanced Alzheimer's disease who recently developed influenza

Question

Quizplus · Accepted Answer

Hyperosmolar hyperglycemic syndrome is more common in type 2 diabetes; influenza is a stressor that would result in further increases in blood sugar.Some individuals with advanced Alzheimer's disease cannot communicate thirst needs and may be incontinent,making hypertonic fluid loss more difficult to estimate.Uncontrolled type 1 diabetes is associated with diabetic ketoacidosis.Interruption of insulin delivery related to a missed insulin dose in type 1 diabetes creates a situation of absolute insulin deficiency and is associated with diabetic ketoacidosis.A patient with type 2 diabetes who is new to insulin is at risk for hypoglycemia.

Which of the Following Patients Is at the Highest Risk