A 10-year-old boy presents with polyuria, polydipsia and weight loss over 3 weeks. Capillary blood glucose is 22 mmol/L and venous blood gas shows pH ...

Question

A 10-year-old boy presents with polyuria, polydipsia and weight loss over 3 weeks. Capillary blood glucose is 22 mmol/L and venous blood gas shows pH 7.10, bicarbonate 10 mmol/L and ketonaemia. What is the MOST appropriate initial management in ED?

Accepted Answer

Commence isotonic intravenous fluids, then start a fixed-rate insulin infusion after initial resuscitation

Answer

Start intravenous insulin bolus followed by infusion without fluids

Answer

Give subcutaneous insulin and discharge with urgent endocrine follow-up

Answer

Administer sodium bicarbonate bolus to correct acidosis

Answer

Start maintenance fluids only and wait for endocrine advice before insulin

au-acem MCQ (SBA): Diabetic ketoacidosis in children

A 10-year-old boy presents with polyuria, polydipsia and weight loss over 3 weeks. Capillary blood glucose is 22 mmol/L and venous blood gas shows pH 7.10, bicarbonate 10 mmol/L and ketonaemia. What is the MOST appropriate initial management in ED?