Question

A 52-year-old with T2DM presents with polyuria and confusion. Glucose 560 mg/dL, pH 7.08, bicarbonate 8 mEq/L, anion gap 26, serum ketones positive, K+ 4.9 mEq/L, normal creatinine. Initial insulin strategy?

Accepted Answer

IV regular insulin bolus 0.1 U/kg then 0.1 U/kg/h infusion

Answer

Subcutaneous rapid-acting insulin every 2 hours

Answer

IV insulin infusion at 0.05 U/kg/h without a bolus

Answer

Start insulin only after K+ is <3.5 mEq/L

Answer

Give basal insulin only and fluids

Practice question

A 52-year-old with T2DM presents with polyuria and confusion. Glucose 560 mg/dL, pH 7.08, bicarbonate 8 mEq/L, anion gap 26, serum ketones positive, K+ 4.9 mEq/L, normal creatinine. Initial insulin strategy?