Question

A 25-year-old woman with type 1 diabetes presents with nausea, vomiting, abdominal pain and Kussmaul respirations. Capillary glucose is 24 mmol/L, serum ketones are elevated, and arterial blood gas shows pH 7.21 and bicarbonate 10 mmol/L. What is the first priority in her management?

Accepted Answer

Begin aggressive fluid resuscitation with isotonic saline

Answer

Administer a bolus of intravenous regular insulin immediately

Answer

Start intravenous bicarbonate to correct the acidosis

Answer

Restrict oral intake and observe on the ward

Answer

Give subcutaneous rapid-acting insulin and discharge with close follow-up

Practice question

A 25-year-old woman with type 1 diabetes presents with nausea, vomiting, abdominal pain and Kussmaul respirations. Capillary glucose is 24 mmol/L, serum ketones are elevated, and arterial blood gas shows pH 7.21 and bicarbonate 10 mmol/L. What is the first priority in her management?