Question

A 73-year-old woman with confusion and severe hyperglycaemia (glucose 38 mmol/L) has osmolality 330 mOsm/kg and no significant ketonaemia. Which is the most appropriate initial management?

Accepted Answer

Aggressive IV fluids with 0.9% sodium chloride first

Answer

Immediate fixed-rate insulin infusion

Answer

Rapid IV insulin bolus

Answer

IV bicarbonate

Answer

Stop all fluids until osmolality normalises

Practice question

A 73-year-old woman with confusion and severe hyperglycaemia (glucose 38 mmol/L) has osmolality 330 mOsm/kg and no significant ketonaemia. Which is the most appropriate initial management?