Question

A 23-year-old woman with type 1 diabetes presents with 1 day of vomiting and abdominal pain. She is dehydrated and tachycardic. Capillary glucose is 26 mmol/L, venous pH 7.10 and ketones are elevated. Potassium is 4.5 mmol/L. What is the most appropriate initial management step?

Accepted Answer

Begin rapid intravenous 0.9% sodium chloride fluid resuscitation and monitor electrolytes

Answer

Give an intravenous bolus of 10 units of insulin then start an infusion

Answer

Administer intravenous sodium bicarbonate immediately

Answer

Start 5% dextrose infusion at 100 mL/h

Answer

Give subcutaneous long-acting insulin and discharge once glucose falls below 15 mmol/L

Practice question

A 23-year-old woman with type 1 diabetes presents with 1 day of vomiting and abdominal pain. She is dehydrated and tachycardic. Capillary glucose is 26 mmol/L, venous pH 7.10 and ketones are elevated. Potassium is 4.5 mmol/L. What is the most appropriate initial management step?