Which symptom is associated with acute hyperglycemia (diabetic coma/ketoacidosis)?

• A. Abdominal pain
• B. Nausea and vomiting
• C. Lethargy
• D. Intense thirst

Answer: (D)

High blood glucose triggers osmotic diuresis, where the kidneys excrete glucose in the urine and pull water with it. This fluid loss leads to dehydration, which stimulates thirst. Because of this mechanism, intense thirst is a classic, early sign of acute hyperglycemia and diabetic ketoacidosis.

Abdominal pain and nausea/vomiting can occur with diabetic ketoacidosis but are not as directly tied to the hyperglycemic state as thirst. Lethargy can also be present in severe cases due to dehydration, acidosis, or electrolyte disturbances, but the strongest, most consistent symptom linked to the acute rise in glucose is the sensation of thirst.