Question

A patient with diabetic ketoacidosis has been on a fixed-rate insulin infusion for several hours. His blood glucose has fallen from 28 mmol/L to 11 mmol/L, but his blood ketones remain elevated at 4 mmol/L and bicarbonate is still low. What adjustment to his treatment is most appropriate?

Accepted Answer

Add intravenous 10% dextrose and continue the fixed-rate insulin infusion

Answer

Stop the insulin infusion now that glucose is near normal

Answer

Reduce the insulin rate and stop fluids

Answer

Switch to subcutaneous long-acting insulin immediately

Answer

Give a single bolus of rapid-acting insulin subcutaneously and stop IV insulin

Practice question

A patient with diabetic ketoacidosis has been on a fixed-rate insulin infusion for several hours. His blood glucose has fallen from 28 mmol/L to 11 mmol/L, but his blood ketones remain elevated at 4 mmol/L and bicarbonate is still low. What adjustment to his treatment is most appropriate?