Question

A 45-year-old with type 2 diabetes presents with nausea and abdominal pain. Labs: glucose 432 mg/dL, pH 7.21, bicarbonate 12 mEq/L, positive serum ketones, anion gap 24. After fluids and potassium repletion to 4.2 mEq/L, which insulin strategy is recommended?

Accepted Answer

IV regular insulin infusion 0.1 units/kg/hour (without routine bolus)

Answer

IV regular insulin 0.1 units/kg bolus only

Answer

Subcutaneous rapid-acting insulin every 6 hours

Answer

IV regular insulin infusion 0.01 units/kg/hour

Answer

Delay insulin until glucose <250 mg/dL

Practice question

A 45-year-old with type 2 diabetes presents with nausea and abdominal pain. Labs: glucose 432 mg/dL, pH 7.21, bicarbonate 12 mEq/L, positive serum ketones, anion gap 24. After fluids and potassium repletion to 4.2 mEq/L, which insulin strategy is recommended?