Question

A 23-year-old woman with type 1 diabetes presents with abdominal pain, vomiting and drowsiness after a viral illness. Capillary glucose is 25 mmol/L, ketones 5.6 mmol/L, arterial pH 7.15 and bicarbonate 12 mmol/L. What is the most appropriate initial management step in hospital?

Accepted Answer

Give a 1 L bolus of 0.9% sodium chloride over 1 hour

Answer

Start variable-rate insulin infusion and restrict fluids

Answer

Give IV sodium bicarbonate

Answer

Start subcutaneous rapid-acting insulin every hour

Answer

Delay fluids until ketone levels are confirmed in the lab

Practice question

A 23-year-old woman with type 1 diabetes presents with abdominal pain, vomiting and drowsiness after a viral illness. Capillary glucose is 25 mmol/L, ketones 5.6 mmol/L, arterial pH 7.15 and bicarbonate 12 mmol/L. What is the most appropriate initial management step in hospital?