Question

A 40-year-old woman has A1C 12.8%, anion gap 22, beta-hydroxybutyrate elevated, K+ 3.4 mEq/L, bicarbonate 12 mEq/L. First insulin step after initial fluids and potassium repletion to K+ >=3.3?

Accepted Answer

Regular insulin IV bolus 0.1 units/kg then infusion 0.1 units/kg/h

Answer

NPH insulin subcutaneously every 6 hours

Answer

Hold insulin until bicarbonate normalizes

Answer

D10W infusion without insulin

Answer

Insulin glargine only

Practice question

A 40-year-old woman has A1C 12.8%, anion gap 22, beta-hydroxybutyrate elevated, K+ 3.4 mEq/L, bicarbonate 12 mEq/L. First insulin step after initial fluids and potassium repletion to K+ >=3.3?