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Diabetic ketoacidosis — DipIMC MCQ

Instant feedback + full explanation. One question, done properly.

ModerateMedical EmergenciesDiabetic ketoacidosisDipIMC

A 60-year-old man with diabetes is confused and dehydrated. Capillary glucose reads 'HI', respiratory rate is 30 with deep breathing and he smells ketotic. What is the most appropriate transport decision?

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

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Correct answer: E — Transport urgently with pre-alert for suspected diabetic ketoacidosis

Hyperglycaemia with dehydration, Kussmaul breathing and ketotic smell suggests diabetic ketoacidosis, which needs hospital fluids, insulin and electrolyte monitoring. Pre-hospital insulin without potassium monitoring is unsafe. Oral sugary fluids worsen hyperglycaemia and may be unsafe in altered consciousness. The pearl is that DKA is a metabolic emergency even before coma develops.

Reference: JRCALC Guidelines 2025; NICE Diabetes guidance