A 26-year-old woman with type 1 diabetes asks for advice after vomiting for 12 hours. She has glucose 17 mmol/L, blood ketones 1.8 mmol/L and

Question

A 26-year-old woman with type 1 diabetes asks for advice after vomiting for 12 hours. She has glucose 17 mmol/L, blood ketones 1.8 mmol/L and abdominal pain. She uses basal-bolus insulin. What is the most appropriate action?

Accepted Answer

Refer urgently for possible diabetic ketoacidosis while advising not to omit basal insulin

Answer

Advise stopping insulin until vomiting settles

Answer

Advise exercise to reduce glucose and ketones

Answer

Supply oral rehydration salts and review in three days

Answer

Recommend loperamide and a high-fat meal

Diabetic ketoacidosis sick day — GPhC CRA MCQ

A 26-year-old woman with type 1 diabetes asks for advice after vomiting for 12 hours. She has glucose 17 mmol/L, blood ketones 1.8 mmol/L and abdominal pain. She uses basal-bolus insulin. What is the most appropriate action?