Question

A 23-year-old man with type 1 diabetes presents with abdominal pain, vomiting and drowsiness. His capillary glucose is 28 mmol/L, ketones 5.5 mmol/L, pH 7.12 and serum bicarbonate 10 mmol/L. Blood pressure is 96/60 mmHg and pulse 118 bpm. What is the most appropriate immediate management step?

Accepted Answer

Start intravenous 0.9% sodium chloride bolus and fixed-rate insulin infusion according to local DKA protocol

Answer

Give 10 units of rapid-acting insulin subcutaneously and review in 4 hours

Answer

Restrict all fluids until urine output is measured

Answer

Administer intravenous 5% dextrose immediately to reduce ketone production

Answer

Start intravenous insulin only once blood glucose exceeds 30 mmol/L

Practice question

A 23-year-old man with type 1 diabetes presents with abdominal pain, vomiting and drowsiness. His capillary glucose is 28 mmol/L, ketones 5.5 mmol/L, pH 7.12 and serum bicarbonate 10 mmol/L. Blood pressure is 96/60 mmHg and pulse 118 bpm. What is the most appropriate immediate management step?