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Recurrent diabetic ketoacidosis — SCE Endocrinology MCQ

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ModerateDiabetesRecurrent diabetic ketoacidosisSCE Endocrinology

A 19-year-old woman with type 1 diabetes has recurrent DKA admissions. Downloaded glucose data show frequent missed mealtime boluses but appropriate basal insulin. She says she feels overwhelmed and avoids checking glucose at college. What is the most appropriate management?

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

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Correct answer: A — Structured psychosocial and diabetes specialist review focused on insulin omission

Recurrent DKA from missed boluses requires specialist diabetes and psychosocial assessment rather than simply escalating basal insulin. Written advice alone is inadequate where behaviour, distress or eating disorder risk may be present. The pearl is that recurrent DKA is often a marker of psychosocial need.

Reference: NICE NG17; JBDS DKA Guideline