A 24-year-old woman with type 1 diabetes presents with vomiting and polyuria. Blood glucose is 28 mmol/L, ketones 6.2 mmol/L, venous pH 7.18,

Question

A 24-year-old woman with type 1 diabetes presents with vomiting and polyuria. Blood glucose is 28 mmol/L, ketones 6.2 mmol/L, venous pH 7.18, bicarbonate 9 mmol/L and potassium 5.4 mmol/L. She is tachycardic and clinically dehydrated. What is the most appropriate management?

Accepted Answer

Start fixed-rate intravenous insulin with intravenous 0.9% sodium chloride

Answer

Delay insulin until potassium normalises

Answer

Give subcutaneous rapid-acting insulin every 4 hours

Answer

Start intravenous bicarbonate as first-line treatment

Answer

Treat with oral fluids and antiemetics

Diabetic ketoacidosis — SCE Endocrinology MCQ

A 24-year-old woman with type 1 diabetes presents with vomiting and polyuria. Blood glucose is 28 mmol/L, ketones 6.2 mmol/L, venous pH 7.18, bicarbonate 9 mmol/L and potassium 5.4 mmol/L. She is tachycardic and clinically dehydrated. What is the most appropriate management?