A 29-year-old with type 1 diabetes has vomiting, beta-hydroxybutyrate 6.2 mmol/L, venous pH 7.14, bicarbonate 9 mmol/L, glucose 18.4 mmol/L and

Question

A 29-year-old with type 1 diabetes has vomiting, beta-hydroxybutyrate 6.2 mmol/L, venous pH 7.14, bicarbonate 9 mmol/L, glucose 18.4 mmol/L and potassium 5.2 mmol/L. She is clinically dehydrated. Which treatment package is appropriate?

Accepted Answer

Start monitored isotonic fluid, insulin and potassium management

Answer

Withhold all insulin until potassium falls below 4.0 mmol/L

Answer

Give subcutaneous correction insulin without monitoring acid-base resolution

Answer

Use oral rehydration and discharge after an extra basal-insulin dose

Answer

Give intravenous bicarbonate as the primary treatment at this pH

Diabetic ketoacidosis — RCPSC IM MCQ

A 29-year-old with type 1 diabetes has vomiting, beta-hydroxybutyrate 6.2 mmol/L, venous pH 7.14, bicarbonate 9 mmol/L, glucose 18.4 mmol/L and potassium 5.2 mmol/L. She is clinically dehydrated. Which treatment package is appropriate?