Question

A 25-year-old man with type 1 diabetes presents with abdominal pain, vomiting and lethargy. He has Kussmaul respirations and smells of ketones. Capillary glucose is 26 mmol/L, blood ketones 5.5 mmol/L and venous pH 7.12. What is the most appropriate initial fluid therapy?

Accepted Answer

Bolus 500 mL 0.9% sodium chloride over 10–15 minutes

Answer

Bolus 500 mL 5% dextrose over 10–15 minutes

Answer

Start an insulin infusion and delay fluids until laboratory results are available

Answer

Give intravenous sodium bicarbonate

Answer

Restrict fluids to avoid cerebral oedema

Practice question

A 25-year-old man with type 1 diabetes presents with abdominal pain, vomiting and lethargy. He has Kussmaul respirations and smells of ketones. Capillary glucose is 26 mmol/L, blood ketones 5.5 mmol/L and venous pH 7.12. What is the most appropriate initial fluid therapy?