Question

A 26-year-old man with type 1 diabetes presents with 1 day of polyuria, vomiting and abdominal pain. He appears dehydrated and drowsy. Capillary glucose is 28 mmol/L, venous pH 7.12, bicarbonate 10 mmol/L and blood ketones 6.0 mmol/L. Which of the following is the most important initial management step after confirming diabetic ketoacidosis and starting standard monitoring?

Accepted Answer

Begin aggressive intravenous fluid resuscitation with 0.9% sodium chloride

Answer

Start fixed-rate intravenous insulin infusion and delay fluids

Answer

Give a bolus of short-acting insulin followed by infusion

Answer

Restrict fluid intake to avoid cerebral oedema

Answer

Administer intravenous sodium bicarbonate routinely

Practice question