A 22-year-old woman with type 1 diabetes presents with vomiting and abdominal pain. Glucose is 29 mmol/L, ketones are 5.8 mmol/L, pH is 7.12 and

Question

A 22-year-old woman with type 1 diabetes presents with vomiting and abdominal pain. Glucose is 29 mmol/L, ketones are 5.8 mmol/L, pH is 7.12 and potassium is 3.2 mmol/L. She is tachycardic and clinically dehydrated. What is the most appropriate management?

Accepted Answer

Begin intravenous fluids and potassium replacement before fixed-rate insulin infusion

Answer

Start insulin immediately without potassium replacement

Answer

Give subcutaneous rapid-acting insulin and discharge

Answer

Treat with bicarbonate as routine first-line therapy

Answer

Withhold fluids until serum osmolality is normal

Diabetic ketoacidosis — RACP Adult Medicine MCQ

A 22-year-old woman with type 1 diabetes presents with vomiting and abdominal pain. Glucose is 29 mmol/L, ketones are 5.8 mmol/L, pH is 7.12 and potassium is 3.2 mmol/L. She is tachycardic and clinically dehydrated. What is the most appropriate management?