Question

A 25-year-old man with type 1 diabetes presents with polyuria, vomiting and abdominal pain. His capillary glucose is 25 mmol/L, venous pH is 7.12, bicarbonate 10 mmol/L and serum ketones are strongly positive. What is the most appropriate insulin strategy after initial fluid resuscitation?

Accepted Answer

Intravenous insulin infusion at 0.1 units/kg/h

Answer

Intravenous insulin bolus only, no infusion

Answer

Subcutaneous rapid-acting insulin every 6 hours

Answer

High-dose subcutaneous insulin glargine once

Answer

Delay insulin until ketones clear with fluids alone

Practice question

A 25-year-old man with type 1 diabetes presents with polyuria, vomiting and abdominal pain. His capillary glucose is 25 mmol/L, venous pH is 7.12, bicarbonate 10 mmol/L and serum ketones are strongly positive. What is the most appropriate insulin strategy after initial fluid resuscitation?