Question

A 45-year-old man with obesity and T2D presents with DKA. After initial fluids and potassium correction, an insulin infusion at 0.1 units/kg/hr is started. Glucose falls to 220 mg/dL while anion gap persists. Best next step?

Accepted Answer

Add dextrose to IV fluids and continue insulin to clear ketones

Answer

Stop insulin infusion

Answer

Give sodium bicarbonate

Answer

Switch to subcutaneous sliding scale insulin

Answer

Bolus insulin 10 units IV then stop

Practice question

A 45-year-old man with obesity and T2D presents with DKA. After initial fluids and potassium correction, an insulin infusion at 0.1 units/kg/hr is started. Glucose falls to 220 mg/dL while anion gap persists. Best next step?