Question

A 68-year-old man with type 2 diabetes presents with DKA. After insulin and fluids, glucose reaches 200 mg/dL but anion gap remains elevated. Next fluid adjustment?

Accepted Answer

Add dextrose to fluids (e.g., D5½NS) and continue insulin to clear ketones

Answer

Stop insulin infusion immediately

Answer

Switch to bicarbonate infusion in all

Answer

Hold dextrose to keep glucose low

Answer

Switch to subcutaneous insulin immediately

Practice question

A 68-year-old man with type 2 diabetes presents with DKA. After insulin and fluids, glucose reaches 200 mg/dL but anion gap remains elevated. Next fluid adjustment?