Question

A 60-year-old with T2D is admitted with HHS (glucose 980 mg/dL, serum osm 335 mOsm/kg, pH 7.35). Initial insulin management?

Accepted Answer

After initial fluids and ensuring K+ >= 3.3, start IV insulin infusion (e.g., 0.1 U/kg/h)

Answer

Give insulin bolus only then stop

Answer

No insulin needed in HHS

Answer

Start basal-bolus SC insulin immediately without IV

Answer

Delay insulin until glucose <250 mg/dL from fluids alone

Practice question

A 60-year-old with T2D is admitted with HHS (glucose 980 mg/dL, serum osm 335 mOsm/kg, pH 7.35). Initial insulin management?