The blood glucose value is critical; negative ketones is consistent with type 2 diabetes. An elderly type 2 diabetic patient is at risk for hyperosmolar non-ketotic coma and osmolality should be measured.

A measurement of urine glucose would not be useful at this point.

A 70-year-old type 2 diabetic patient is comatose and in the emergency department. Stat blood glucose and serum ketones are ordered.

Blood Glucose: 650 mg/dL

Serum Ketones: Negative

What is the best conclusion?