Question

A 60-year-old woman with suspected DKA has glucose 360 mg/dL, anion gap 24, bicarbonate 10 mEq/L, and pH 7.21. Potassium is 4.8 mEq/L. After 2 L of lactated Ringer's, which insulin strategy is appropriate?

Accepted Answer

IV regular insulin infusion 0.1 units/kg/h without dextrose until glucose ~200-250 mg/dL

Answer

IV regular insulin bolus 10 units only

Answer

Subcutaneous NPH insulin every 6 hours

Answer

Delay insulin until pH <7.0

Answer

Add dextrose immediately to IV fluids

Practice question

A 60-year-old woman with suspected DKA has glucose 360 mg/dL, anion gap 24, bicarbonate 10 mEq/L, and pH 7.21. Potassium is 4.8 mEq/L. After 2 L of lactated Ringer's, which insulin strategy is appropriate?