Question

A 24-year-old woman with type 1 diabetes presents with abdominal pain, vomiting and polyuria. She is tachycardic, Kussmaul breathing and ketotic. Capillary glucose is 25 mmol/L, ketones 5 mmol/L, pH 7.15. What is the most appropriate initial management step?

Accepted Answer

Begin fixed-rate IV insulin infusion and aggressive IV fluid resuscitation with close monitoring

Answer

Start IV insulin bolus followed by variable-rate insulin infusion without fluids

Answer

Give subcutaneous rapid-acting insulin only

Answer

Start bicarbonate infusion routinely

Answer

Delay insulin until ketones fall spontaneously

Practice question

A 24-year-old woman with type 1 diabetes presents with abdominal pain, vomiting and polyuria. She is tachycardic, Kussmaul breathing and ketotic. Capillary glucose is 25 mmol/L, ketones 5 mmol/L, pH 7.15. What is the most appropriate initial management step?