Question

A 23-year-old man with type 1 diabetes presents with abdominal pain, vomiting and polyuria. Blood glucose is 28 mmol/L, venous pH 7.15, bicarbonate 10 mmol/L and ketones 5.2 mmol/L. What is the single most important initial management step?

Accepted Answer

Give 1 litre of 0.9% sodium chloride over the first hour

Answer

Start a fixed-rate intravenous insulin infusion without fluids

Answer

Give a bolus of intravenous insulin then start an infusion

Answer

Start 10% dextrose infusion immediately

Answer

Give subcutaneous rapid-acting insulin every hour

Practice question

A 23-year-old man with type 1 diabetes presents with abdominal pain, vomiting and polyuria. Blood glucose is 28 mmol/L, venous pH 7.15, bicarbonate 10 mmol/L and ketones 5.2 mmol/L. What is the single most important initial management step?