North Carolina EMT State Practice Exam

What causes altered mental status in hyperglycemia?

1. Acidosis

2. Dehydration of the brain cells

3. Excessive insulin production

4. Lack of oxygen to the brain

The correct answer is: Dehydration of the brain cells

Altered mental status in hyperglycemia is often caused by the dehydration of brain cells, which occurs due to an osmotic imbalance. When blood sugar levels rise significantly, it leads to an increase in osmotic pressure in the bloodstream. This condition causes water to be drawn out of cells, including brain cells, resulting in cellular dehydration. As brain cells become dehydrated, their ability to function properly is impaired, which can manifest as confusion, disorientation, or decreased consciousness. This mechanism is particularly important in the context of hyperglycemic states such as diabetic ketoacidosis (DKA) or hyperglycemic hyperosmolar state (HHS), where elevated blood sugar levels create a significant fluid and electrolyte imbalance. Understanding this pathway is crucial, as it highlights the importance of rapid intervention to restore normal blood glucose levels and rehydrate the individual to prevent serious neurological consequences.