A 79-year-old with confusion, glucose 34 mmol/L, osmolality high, small urinary ketones. What is the priority initial management?...

Question

A 79-year-old with confusion, glucose 34 mmol/L, osmolality high, small urinary ketones. What is the priority initial management?

Accepted Answer

Aggressive IV fluids with 0.9% sodium chloride first, insulin later if needed

Answer

Immediate IV insulin bolus then infusion

Answer

Immediate bicarbonate infusion

Answer

SC rapid-acting insulin hourly

Answer

No fluids to avoid pulmonary oedema

mrcp part 1 MCQ (SBA): Hyperosmolar hyperglycaemic state