New onset type 2 diabetes often presents with which condition?

New onset type 2 diabetes often presents with which condition?

• A. Hyperosmolar Hyperglycemic State
• B. Diabetic ketoacidosis
• C. Hypoglycemia
• D. Lactic acidosis

Answer: (A)

Hyperosmolar hyperglycemic state is the typical presentation of new-onset type 2 diabetes because there is enough circulating insulin to prevent significant ketoacidosis, but not enough to prevent extreme hyperglycemia. This severe high glucose causes marked osmotic diuresis, leading to dehydration and an elevated serum osmolality. Since ketosis is minimal, there is little or no metabolic acidosis, which distinguishes it from diabetic ketoacidosis. In contrast, diabetic ketoacidosis is more common when insulin deficiency is profound (often in type 1 or in type 2 under stress), and presents with high ketones and acidosis. Hypoglycemia is not a presenting feature of new-onset hyperglycemia, and lactic acidosis is not characteristic of new-onset type 2 diabetes.

Hyperosmolar hyperglycemic state is the typical presentation of new-onset type 2 diabetes because there is enough circulating insulin to prevent significant ketoacidosis, but not enough to prevent extreme hyperglycemia. This severe high glucose causes marked osmotic diuresis, leading to dehydration and an elevated serum osmolality. Since ketosis is minimal, there is little or no metabolic acidosis, which distinguishes it from diabetic ketoacidosis. In contrast, diabetic ketoacidosis is more common when insulin deficiency is profound (often in type 1 or in type 2 under stress), and presents with high ketones and acidosis. Hypoglycemia is not a presenting feature of new-onset hyperglycemia, and lactic acidosis is not characteristic of new-onset type 2 diabetes.