A 50-year-old with T2DM on basal insulin is admitted with DKA. Initial labs: glucose 28.9 mmol/L, K⁺ 4.6 mEq/L, pH 7.12, anion gap 24. After 1 L LR,

Question

A 50-year-old with T2DM on basal insulin is admitted with DKA. Initial labs: glucose 28.9 mmol/L, K⁺ 4.6 mEq/L, pH 7.12, anion gap 24. After 1 L LR, next best insulin strategy?

Accepted Answer

Begin IV regular insulin infusion at 0.1 units/kg/h (after potassium confirmed ≥3.3 mEq/L)

Answer

Hold insulin until glucose

Answer

Give insulin bolus 1 unit/kg then stop

Answer

Give subcutaneous sliding-scale insulin only

Answer

Start insulin only after bicarbonate infusion

Diabetic Ketoacidosis — SCE Endocrinology MCQ

A 50-year-old with T2DM on basal insulin is admitted with DKA. Initial labs: glucose 28.9 mmol/L, K⁺ 4.6 mEq/L, pH 7.12, anion gap 24. After 1 L LR, next best insulin strategy?