Question

A 60-year-old with type 2 diabetes presents in DKA: glucose 520 mg/dL, pH 7.15, bicarbonate 10 mEq/L, anion gap 26, K⁺ 5.0 mEq/L. After initial 1-1.5 L isotonic fluid in the first hour, best insulin strategy?

Accepted Answer

Start IV regular insulin infusion 0.1 units/kg/h (with or without 0.1 units/kg bolus)

Answer

IV insulin bolus 10 units once only

Answer

Start subcutaneous rapid-acting insulin every 6 hours

Answer

Withhold insulin until K⁺ <3.3 mEq/L

Answer

Start insulin infusion 0.01 units/kg/h

Practice question

A 60-year-old with type 2 diabetes presents in DKA: glucose 520 mg/dL, pH 7.15, bicarbonate 10 mEq/L, anion gap 26, K⁺ 5.0 mEq/L. After initial 1-1.5 L isotonic fluid in the first hour, best insulin strategy?