Question

A 25-year-old with type 1 diabetes presents with DKA (glucose 520 mg/dL, pH 7.18, HCO₃⁻ 10 mEq/L, anion gap 24). Serum K⁺ is 2.9 mEq/L. What is the next best step?

Accepted Answer

Give IV bicarbonate

Answer

Start IV regular insulin infusion at 0.1 units/kg/h now

Answer

Give subcutaneous rapid-acting insulin and fluids

Answer

Begin IV potassium replacement and delay insulin until K⁺ ≥3.3 mEq/L

Answer

No potassium needed; start insulin and aggressive fluids

Practice question

A 25-year-old with type 1 diabetes presents with DKA (glucose 520 mg/dL, pH 7.18, HCO₃⁻ 10 mEq/L, anion gap 24). Serum K⁺ is 2.9 mEq/L. What is the next best step?