A 9-year-old presents with polyuria, weight loss, vomiting and abdominal pain. He is dehydrated with Kussmaul breathing; glucose is 28 mmol/L,

Question

A 9-year-old presents with polyuria, weight loss, vomiting and abdominal pain. He is dehydrated with Kussmaul breathing; glucose is 28 mmol/L, ketones are high, pH is 7.16 and potassium is 4.8 mmol/L. What is the most appropriate management?

Accepted Answer

Careful intravenous fluids and insulin infusion with electrolyte monitoring

Answer

Fluid restriction until glucose falls below 15 mmol/L

Answer

Sodium bicarbonate infusion as routine first-line therapy

Answer

Long-acting insulin alone with outpatient review

Answer

Subcutaneous rapid-acting insulin and oral fluids at home

Diabetic ketoacidosis — RACP Paediatrics MCQ

A 9-year-old presents with polyuria, weight loss, vomiting and abdominal pain. He is dehydrated with Kussmaul breathing; glucose is 28 mmol/L, ketones are high, pH is 7.16 and potassium is 4.8 mmol/L. What is the most appropriate management?