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Case Reports
. 2025 Jun 3:2025:4737440.
doi: 10.1155/crie/4737440. eCollection 2025.

Successful Management of Extreme Hyperglycemia (134 mmol/L) Secondary to Chronic Pancreatitis Causing Critical Hyperosmolar Coma: A Case Report

Arnaud Robert  1 , Sandra Ihirwe Habineza  1 , David Leng  1 , Chloé Dieudonné  2 , Patrick M Honoré  1 , Pierre Bulpa  1
Affiliations
Case Reports

Successful Management of Extreme Hyperglycemia (134 mmol/L) Secondary to Chronic Pancreatitis Causing Critical Hyperosmolar Coma: A Case Report

Arnaud Robert et al. Case Rep Endocrinol. .

Abstract

Hyperosmolar hyperglycemic state (HHS) is a life-threatening condition characterized by extreme hyperglycemia, high plasma osmolality, and severe dehydration without significant ketoacidosis. Prompt diagnosis and appropriate management are essential to reduce morbidity and mortality, which range from 10% to 20%. We report a case of a 50-year-old man with insulin-dependent diabetes mellitus secondary to chronic alcoholic pancreatitis presenting with severe HHS and coma. His initial blood glucose level was 134 mmol/L (2420 mg/dL), and serum osmolality was 416 mOsm/kg. Despite the critical condition at admission, the patient responded well to intensive therapy, including insulin infusion and intravenous fluids, and could be discharged without any neurological sequelae.

Keywords: case report; diabetes mellitus; hyperosmolality; hyperosmolar hyperglycemic state; insulin therapy; intensive care.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Evolution of blood glucose during time in ICU.
Figure 2
Figure 2
Evolution of corrected and measured natremia over time.
See this image and copyright information in PMC

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