Question

An 82-year-old with type 2 diabetes presents dehydrated, confused, glucose 38 mmol/L, ketones 0.6 mmol/L, osmolality high. What is the key first-line management for HHS?

Accepted Answer

Gradual IV 0.9% saline rehydration; start insulin later if needed

Answer

Immediate high-dose insulin bolus

Answer

IV bicarbonate

Answer

Rapid 5% dextrose infusion only

Answer

No fluids to avoid heart failure

Practice question

An 82-year-old with type 2 diabetes presents dehydrated, confused, glucose 38 mmol/L, ketones 0.6 mmol/L, osmolality high. What is the key first-line management for HHS?