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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\u2010year\u2010old man with insulin\u2010dependent diabetes mellitus secondary to chronic alcoholic pancreatitis presenting with severe HHS and coma. His initial blood glucose level was 134\u2009mmol\/L (2420\u2009mg\/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.<\/jats:p>","DOI":"10.1155\/crie\/4737440","type":"journal-article","created":{"date-parts":[[2025,6,3]],"date-time":"2025-06-03T04:03:31Z","timestamp":1748923411000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Successful Management of Extreme Hyperglycemia (134 mmol\/L) Secondary to Chronic Pancreatitis Causing Critical Hyperosmolar Coma: A Case Report"],"prefix":"10.1155","volume":"2025","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8023-6483","authenticated-orcid":false,"given":"Arnaud","family":"Robert","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sandra","family":"Ihirwe Habineza","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David","family":"Leng","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chlo\u00e9","family":"Dieudonn\u00e9","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6697-4890","authenticated-orcid":false,"given":"Patrick M.","family":"Honor\u00e9","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7655-0653","authenticated-orcid":false,"given":"Pierre","family":"Bulpa","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,6,3]]},"reference":[{"key":"e_1_2_9_1_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00125-024-06183-8"},{"key":"e_1_2_9_2_2","doi-asserted-by":"publisher","DOI":"10.2337\/dc14-0984"},{"key":"e_1_2_9_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.diabres.2011.06.018"},{"key":"e_1_2_9_4_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13098-023-01020-1"},{"key":"e_1_2_9_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.endinu.2025.501577"},{"key":"e_1_2_9_6_2","doi-asserted-by":"publisher","DOI":"10.1007\/s001250051130"},{"key":"e_1_2_9_7_2","first-page":"729","article-title":"Hyperosmolar Hyperglycemic State","volume":"96","author":"Stoner G. 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