Question

A 72-year-old woman with T2DM and CKD eGFR 34 is admitted with HHS. After fluids, insulin infusion starts at 0.05 U/kg/h. When glucose reaches 250 mg/dL and osmolality remains high, next step?

Accepted Answer

Add dextrose to fluids and continue insulin until osmolality improves

Answer

Stop insulin when glucose <250

Answer

Switch to SQ insulin immediately

Answer

Give bicarbonate

Answer

No further insulin needed

Practice question

A 72-year-old woman with T2DM and CKD eGFR 34 is admitted with HHS. After fluids, insulin infusion starts at 0.05 U/kg/h. When glucose reaches 250 mg/dL and osmolality remains high, next step?