Question

A 23-year-old woman with type 1 diabetes presents with abdominal pain and vomiting. Capillary glucose is 26 mmol/L, ketones 4.5 mmol/L and venous blood gas shows pH 7.21 and bicarbonate 12 mmol/L. What is the single most important initial management step?

Accepted Answer

Rapid intravenous infusion of 0.9% sodium chloride

Answer

Start fixed-rate intravenous insulin infusion immediately

Answer

Give a bolus of intravenous sodium bicarbonate

Answer

Start long-acting insulin at double her usual dose

Answer

Restrict oral fluids and observe

Practice question

A 23-year-old woman with type 1 diabetes presents with abdominal pain and vomiting. Capillary glucose is 26 mmol/L, ketones 4.5 mmol/L and venous blood gas shows pH 7.21 and bicarbonate 12 mmol/L. What is the single most important initial management step?