A young patient with type 1 diabetes is unwell with deep sighing respiration and a ketotic smell to the breath. The capillary glucose is 28 mmol/L

Question

A young patient with type 1 diabetes is unwell with deep sighing respiration and a ketotic smell to the breath. The capillary glucose is 28 mmol/L with high ketones. He is dehydrated, with a heart rate of 120 and a blood pressure of 95/60.

Accepted Answer

Give intravenous fluid resuscitation and arrange urgent transfer for insulin therapy.

Answer

Give oral rehydration and arrange a GP review.

Answer

Withhold fluids to avoid cerebral oedema and transport slowly.

Answer

Give intravenous glucose to correct presumed hypoglycaemia.

Answer

Give a single dose of subcutaneous rapid-acting insulin and observe the patient at home.

Diabetic ketoacidosis — DIPIMC MCQ

A young patient with type 1 diabetes is unwell with deep sighing respiration and a ketotic smell to the breath. The capillary glucose is 28 mmol/L with high ketones. He is dehydrated, with a heart rate of 120 and a blood pressure of 95/60.