A 28-year-old with DKA is started on IV insulin at 0.1 units/kg/hour after fluids. When plasma glucose falls to 190 mg/dL and anion gap remains elevat...

Question

A 28-year-old with DKA is started on IV insulin at 0.1 units/kg/hour after fluids. When plasma glucose falls to 190 mg/dL and anion gap remains elevated, what is the next step?

Accepted Answer

Add dextrose to fluids and reduce insulin to 0.02-0.05 units/kg/hour until ketoacidosis resolves

Answer

Stop insulin and switch to subcutaneous regimen immediately

Answer

Reduce insulin to 0.02-0.05 units/kg/hour and stop all dextrose

Answer

Continue insulin at the same rate and keep isotonic saline only

Answer

Give IV bicarbonate to hasten closure of the gap

us-abem MCQ (SBA): Diabetic Ketoacidosis

A 28-year-old with DKA is started on IV insulin at 0.1 units/kg/hour after fluids. When plasma glucose falls to 190 mg/dL and anion gap remains elevated, what is the next step?