Question

A 45-year-old man with type 1 diabetes presents with abdominal pain, vomiting and lethargy. His capillary blood glucose is 28 mmol/L, ketones 5.5 mmol/L, arterial pH 7.15 and bicarbonate 10 mmol/L. According to UK DKA protocols, what is the most important initial fluid management step?

Accepted Answer

Rapid bolus of 1 litre 0.9% sodium chloride over 15–30 minutes

Answer

Start an insulin infusion before giving fluids

Answer

Give 5% dextrose at 125 mL/hour

Answer

Restrict fluids to avoid cerebral oedema

Answer

Give half-normal (0.45%) saline to correct free water deficit

Practice question

A 45-year-old man with type 1 diabetes presents with abdominal pain, vomiting and lethargy. His capillary blood glucose is 28 mmol/L, ketones 5.5 mmol/L, arterial pH 7.15 and bicarbonate 10 mmol/L. According to UK DKA protocols, what is the most important initial fluid management step?