Question

A 22-year-old man with type 1 diabetes presents with abdominal pain, vomiting and polyuria. His capillary glucose is 28 mmol/L, venous pH 7.12 and ketones 5.6 mmol/L. He is tachycardic and mildly hypotensive. What is the single most appropriate initial management step?

Accepted Answer

Start intravenous 0.9% sodium chloride fluid resuscitation

Answer

Start an intravenous insulin infusion immediately without fluids

Answer

Restrict fluid intake to avoid cerebral oedema

Answer

Give a bolus of intravenous insulin followed by subcutaneous insulin only

Answer

Start 0.45% sodium chloride as the initial resuscitation fluid

Practice question

A 22-year-old man with type 1 diabetes presents with abdominal pain, vomiting and polyuria. His capillary glucose is 28 mmol/L, venous pH 7.12 and ketones 5.6 mmol/L. He is tachycardic and mildly hypotensive. What is the single most appropriate initial management step?