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Diabetic Ketoacidosis — RACP Paediatrics MCQ

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ModerateEndocrinologyDiabetic KetoacidosisRACP Paediatrics

A 10-year-old boy presents to the emergency department with polyuria, polydipsia, weight loss, and abdominal pain. Blood glucose is 28 mmol/L, pH 7.15, bicarbonate 8 mmol/L, and blood ketones 5.2 mmol/L. He weighs 30 kg. What is the recommended initial rate of IV insulin infusion?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: D — 0.1 units/kg/hour

DKA in children is managed with IV fluid resuscitation followed by a continuous insulin infusion at 0.1 units/kg/hour (commenced after the first hour of fluid resuscitation). Insulin should not be given as bolus doses. The insulin infusion is adjusted to reduce blood glucose by approximately 3–5 mmol/L per hour. Insulin is never stopped while the child remains acidotic.

Reference: RCH Melbourne – 2024 – Clinical Practice Guidelines: Diabetic Ketoacidosis