Question

A 48-year-old presents with DKA: glucose 520 mg/dL, pH 7.14, anion gap 22, K⁺ 3.1 mEq/L. Which is the best initial insulin strategy?

Accepted Answer

Hold insulin until potassium is ≥3.3 mEq/L while starting fluids and K⁺ replacement

Answer

Start insulin infusion at 0.1 U/kg/h immediately

Answer

Give insulin bolus then 0.1 U/kg/h infusion immediately

Answer

Begin subcutaneous insulin only

Answer

Begin isotonic fluids and potassium replacement first, then start insulin infusion

Practice question

A 48-year-old presents with DKA: glucose 520 mg/dL, pH 7.14, anion gap 22, K⁺ 3.1 mEq/L. Which is the best initial insulin strategy?