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Diabetic ketoacidosis — SCE Endocrinology MCQ

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EasyDiabetesDiabetic ketoacidosisSCE Endocrinology

A 21-year-old man with type 1 diabetes is brought to hospital with vomiting and abdominal pain. Glucose is 31 mmol/L, pH 7.12, bicarbonate 8 mmol/L and capillary ketones 5.8 mmol/L. Potassium is 4.9 mmol/L. What is the most appropriate initial management?

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Correct answer: A — Fixed-rate intravenous insulin with 0.9% sodium chloride

This is diabetic ketoacidosis and should be managed with fixed-rate intravenous insulin and 0.9% sodium chloride according to JBDS guidance. Bicarbonate is not routine and stopping basal insulin risks rebound ketosis. Potassium replacement depends on serial potassium values, but insulin and fluids are the central early therapy.

Reference: JBDS Inpatient Diabetes Guidelines; BNF