A 28-year-old with suspected DKA after viral illness. After fluids and insulin infusion, glucose reaches 190 mg/dL while anion gap remains 18. Next in...

Question

A 28-year-old with suspected DKA after viral illness. After fluids and insulin infusion, glucose reaches 190 mg/dL while anion gap remains 18. Next insulin/fluid step?

Accepted Answer

Add dextrose to IV fluids and continue insulin to clear ketosis

Answer

Stop insulin because glucose

Answer

Switch insulin to sliding-scale subcutaneous only

Answer

Give IV bicarbonate because gap persists

Answer

Bolus NPH insulin and stop drip

us-abem MCQ (SBA): DKA Transition Strategy

A 28-year-old with suspected DKA after viral illness. After fluids and insulin infusion, glucose reaches 190 mg/dL while anion gap remains 18. Next insulin/fluid step?