A 28-year-old woman with type 1 diabetes presents with vomiting and abdominal pain. Glucose is 28 mmol/L, capillary ketones are 6.2 mmol/L, venous pH

Question

A 28-year-old woman with type 1 diabetes presents with vomiting and abdominal pain. Glucose is 28 mmol/L, capillary ketones are 6.2 mmol/L, venous pH is 7.12 and potassium is 4.9 mmol/L. She has missed basal insulin for two days. What is the most appropriate next step in management?

Accepted Answer

Start fixed-rate intravenous insulin and 0.9% sodium chloride

Answer

Start 5% glucose as the initial resuscitation fluid

Answer

Withhold insulin until ketones fall spontaneously

Answer

Correct acidosis with intravenous sodium bicarbonate

Answer

Give subcutaneous rapid-acting insulin and discharge

Diabetic ketoacidosis — SCE Acute Medicine MCQ

A 28-year-old woman with type 1 diabetes presents with vomiting and abdominal pain. Glucose is 28 mmol/L, capillary ketones are 6.2 mmol/L, venous pH is 7.12 and potassium is 4.9 mmol/L. She has missed basal insulin for two days. What is the most appropriate next step in management?