Question

A 24-year-old woman with type 1 diabetes presents to the emergency department with abdominal pain, polyuria and vomiting. She has Kussmaul respirations, capillary glucose 25 mmol/L, ketones 4.5 mmol/L and venous pH 7.12. After confirming diabetic ketoacidosis (DKA), what is the most appropriate immediate initial management step?

Accepted Answer

Give rapid intravenous isotonic saline bolus and commence a fixed-rate insulin infusion after initial fluid resuscitation

Answer

Administer an intravenous insulin bolus without fluids

Answer

Commence a fixed-rate intravenous insulin infusion and delay fluids until glucose is <15 mmol/L

Answer

Give intravenous bicarbonate immediately

Answer

Start 10% dextrose infusion to prevent hypoglycaemia

Practice question