Case presentation An 82-year-old gentleman with known type 2 diabetes presented with complaints of general deterioration and acute confusion. His family members said they saw him a week ago when he was absolutely fine. They stress that he is usually in good health and has been managing alone for five years after the death of his wife. He has no history of illness apart from diabetes and ‘mild’ hypertension, both diagnosed ten years ago.
He drinks occasionally (1–4 units/month). Medication history Metformin 850 mg b.d., Gliclazide 40 mg b.d., Aspirin 75 mg o.d., Atorvastatin 10 mg o.d., Bendrofluazide 2.5 mg o.d. Initial assessment Glasgow Coma Scale (GCS): 13/15 (E3, V5, M5) Blood pressure: 100/58 mmHg Pulse: 110/min regular Respiratory rate: 30/min O 2 saturation: 89% Capillary glucose: high On examination, he is clinically dehydrated, although cardiovascular and abdominal examinations…
