Question

A 23-year-old woman with type 1 diabetes presents with 1 day of abdominal pain, vomiting and increasing drowsiness. Capillary glucose is 25 mmol/L, ketones 5.0 mmol/L and venous pH 7.15. What is the most important initial treatment in the emergency department?

Accepted Answer

Aggressive intravenous fluid resuscitation with isotonic crystalloid

Answer

Rapid intravenous insulin bolus without fluids

Answer

Intravenous sodium bicarbonate

Answer

Immediate long-acting subcutaneous insulin only

Answer

Oral rehydration and observation

Practice question

A 23-year-old woman with type 1 diabetes presents with 1 day of abdominal pain, vomiting and increasing drowsiness. Capillary glucose is 25 mmol/L, ketones 5.0 mmol/L and venous pH 7.15. What is the most important initial treatment in the emergency department?