Comatose patients with blood glucose level of 750 mg/dl suggests the possibility of hyperglycemic hyperosmolar state . Lab abnormality in this is marked hyperglycemia, hyperosmolarity, prerenal azotemia. Comatose patients with hyperglycemia is also seen in diabetic ketoacidosis. Thus blood ph ( to detect acidosis) and serum creatinine for azotemia are most impoant investigations.