Question

A 24-year-old woman with type 1 diabetes presents with abdominal pain, vomiting and polyuria. Capillary glucose is 28 mmol per litre, venous pH 7.12, bicarbonate 10 mmol per litre and blood ketones 6 mmol per litre. After ABC assessment, what is the most appropriate initial management step?

Accepted Answer

Start an intravenous insulin infusion at 0.1 units per kg per hour with intravenous 0.9 percent sodium chloride

Answer

Give an intravenous bolus of soluble insulin 10 units

Answer

Start intravenous 5 percent dextrose at 125 mL per hour without saline

Answer

Restrict fluids to 1 litre in the first 12 hours

Answer

Give only long-acting insulin and manage as an outpatient

Practice question

A 24-year-old woman with type 1 diabetes presents with abdominal pain, vomiting and polyuria. Capillary glucose is 28 mmol per litre, venous pH 7.12, bicarbonate 10 mmol per litre and blood ketones 6 mmol per litre. After ABC assessment, what is the most appropriate initial management step?