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Diabetic Ketoacidosis — UKMLA MCQ

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HardEndocrinologyDiabetic KetoacidosisUKMLAMRCP Part 1MRCEM SBAPARAPSA

During DKA treatment, glucose has fallen to 12 mmol/L but ketones remain 2.4 mmol/L. What adjustment supports continued ketone clearance?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: C — Add intravenous dextrose while continuing fixed-rate insulin

The best answer is “Add intravenous dextrose while continuing fixed-rate insulin”. DKA treatment must continue suppressing ketogenesis after glucose falls. Intravenous dextrose is added, commonly when glucose is below 14 mmol/L, so fixed-rate insulin can continue safely until ketones and acidosis resolve. Stopping insulin at the glucose threshold risks persistent or recurrent ketoacidosis.

Reference: Joint British Diabetes Societies: Management of diabetic ketoacidosis in adults: https://abcd.care/resource/current/jbds-02-management-diabetic-ketoacidosis-adults