A 72 year old man with type 2 diabetes is brought for confusion after several days of poor water intake and urinary frequency. Glucose is 920 mg/dL, serum osmolality is markedly elevated, pH is 7.36, and ketones are minimal. Which of the following best explains why significant ketoacidosis is absent?
- A)Hyperkalemia suppresses glucagon release
- B)Excess calcitonin blocks lipolysis
- C)Residual insulin activity suppresses lipolysisGABARITO
- D)Renal bicarbonate wasting prevents ketone formation
- E)TSH directly stimulates glucose uptake
Explicação
Hyperosmolar hyperglycemic state occurs in type 2 diabetes when there is enough endogenous insulin to inhibit hormone sensitive lipase and limit ketogenesis, but not enough to prevent severe hyperglycemia. Therefore marked hyperosmolarity and dehydration predo... Ver explicação completa e trilha adaptativa →