Question

A 62-year-old admitted with HHS (glucose 780 mg/dL, osmolality 330 mOsm/kg, pH 7.36) is obtunded. Initial insulin strategy?

Accepted Answer

Fixed-rate IV insulin infusion (e.g., 0.1 U/kg/h) after initial fluids and potassium assessment

Answer

IV insulin bolus 0.2 U/kg then stop

Answer

Subcutaneous NPH q6h

Answer

No insulin; fluids only

Answer

Start insulin before fluid resuscitation

Practice question

A 62-year-old admitted with HHS (glucose 780 mg/dL, osmolality 330 mOsm/kg, pH 7.36) is obtunded. Initial insulin strategy?