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/...

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

Answer

Switch to SQ insulin immediately

Answer

Give bicarbonate

Answer

No further insulin needed

us-abem MCQ (SBA): HHS-Glucose and Osmolality Management

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?