A 28-year-old woman with type 1 diabetes presents with nausea, abdominal pain and rapid breathing. Capillary glucose is 24 mmol/L, ketones 4.5 mmol/L,...

Question

A 28-year-old woman with type 1 diabetes presents with nausea, abdominal pain and rapid breathing. Capillary glucose is 24 mmol/L, ketones 4.5 mmol/L, and venous pH 7.12. After initial fluid resuscitation with 0.9% sodium chloride, what is the most appropriate next step in management?

Accepted Answer

Commence a fixed-rate IV insulin infusion

Answer

Give IV sodium bicarbonate immediately

Answer

Start long-acting subcutaneous insulin only

Answer

Restrict further fluids until ketones have cleared

Answer

Give a bolus of IV insulin then stop

au-acem MCQ (SBA): DKA management adult

A 28-year-old woman with type 1 diabetes presents with nausea, abdominal pain and rapid breathing. Capillary glucose is 24 mmol/L, ketones 4.5 mmol/L, and venous pH 7.12. After initial fluid resuscitation with 0.9% sodium chloride, what is the most appropriate next step in management?