Question

A 61-year-old with DKA has glucose 220 mg/dL on insulin infusion. Ketones persist; bicarbonate 15 mEq/L. Next insulin step?

Accepted Answer

Reduce insulin infusion to 0.05 units/kg/h and add dextrose-containing fluids

Answer

Stop insulin when glucose <250 mg/dL

Answer

Increase insulin to 0.2 units/kg/h

Answer

Switch to subcutaneous insulin immediately

Answer

Add bicarbonate to all

Practice question

A 61-year-old with DKA has glucose 220 mg/dL on insulin infusion. Ketones persist; bicarbonate 15 mEq/L. Next insulin step?