A case of Hyperglycemic Hyperosmolar State with Hyponatremia and Subsequent Gastrointestinal Bleeding due to Acute Gastric Mucosal Lesions

We present a case of hyperglycemic hyperosmolar state with hyponatremia and subsequent bleeding from acute gastric mucosal lesions. An 84-year-old man with a long history of type 2 diabetes was repeat-edly hospitalized for treatment of congestive heart failure due to coronary artery disease during the past decade and therefore received combination therapy with loop and thiazide diuretics. He was admitted for hyperglycemic hyperosmolar state with hyponatremia and, while hospitalized, developed anemia and bloody stools. Gastroscopy showed gastrointestinal bleeding due to acute gastric mucosal lesions（erosions and ulcers）. Clinicians should keep in mind that acute gastric mucosal lesions can develop as a complica-tion of hyperglycemic hyperosmolar state.