Question

A 28-year-old presents with DKA: glucose 520 mg/dL, pH 7.12, bicarbonate 10 mEq/L, K⁺ 4.9 mEq/L. After fluids, next insulin step?

Accepted Answer

IV insulin infusion 0.1 U/kg/h; add dextrose when glucose <200

Answer

IV regular insulin bolus 0.3 U/kg then no infusion

Answer

Start subcutaneous NPH every 6 hours

Answer

Hold insulin until K⁺ <3.3

Answer

Begin insulin only after pH normalizes

Practice question

A 28-year-old presents with DKA: glucose 520 mg/dL, pH 7.12, bicarbonate 10 mEq/L, K⁺ 4.9 mEq/L. After fluids, next insulin step?