Question

A 24-year-old with type 1 diabetes presents with Kussmaul respirations, glucose 420 mg/dL, pH 7.12, bicarbonate 10 mEq/L, anion gap 24, K 4.9 mEq/L. After initial isotonic fluids, the most appropriate insulin strategy is:

Accepted Answer

Begin IV regular insulin at 0.1 units/kg/hr (no bolus) and titrate

Answer

Give subcutaneous rapid-acting insulin 10 units every hour

Answer

Start insulin only after potassium <3.3 mEq/L

Answer

Administer insulin bolus 0.3 units/kg then infusion 0.05 units/kg/hr

Answer

Hold insulin until glucose <250 mg/dL

Practice question

A 24-year-old with type 1 diabetes presents with Kussmaul respirations, glucose 420 mg/dL, pH 7.12, bicarbonate 10 mEq/L, anion gap 24, K 4.9 mEq/L. After initial isotonic fluids, the most appropriate insulin strategy is: