Question

A 30-year-old woman with type 1 diabetes is admitted with abdominal pain, vomiting and lethargy. Her capillary glucose is 26 mmol/L, ketones 4.5 mmol/L and venous pH 7.16. She is haemodynamically stable. After initial ABCDE assessment and fluid resuscitation with 0.9% sodium chloride, what is the next most appropriate step in managing her diabetic ketoacidosis?

Accepted Answer

Start a fixed-rate IV insulin infusion and monitor potassium closely

Answer

Give an IV bolus of short-acting insulin then 5% dextrose

Answer

Start variable-rate insulin infusion based on capillary glucose only

Answer

Give subcutaneous rapid-acting insulin every 2 hours

Answer

Withhold insulin until ketones fall below 3 mmol/L

Practice question