QuestionSBA
QuestionChoice
This patient is in diabetic ketoacidosis (DKA) by definition. There is universal agreement that the most important initial therapeutic intervention in DKA is appropriate fluid replacement followed by insulin administration. 0.9% sodium chloride solution (‘normal saline’) is the fluid resuscitation of choice according to the latest guidance from the joint British Diabetes Societies.
10005376
a
IV saline (0.9% NaCl)
QuestionChoice
Conversion to a subcutaneous regime should occur when the patient is biochemically stable (capillary ketones less than 0.6 mmol/L AND pH over 7.3) and the patient is ready and able to eat.
10005378
c
Subcutaneous insulin
QuestionChoice
This should occur as step 2 following commencement of 0.9% NaCl. The IV insulin should be given at a rate of 0.1unit/kg/hour.
10005379
d
Intravenous insulin infusion
QuestionChoice
There is universal agreement that the most important initial therapeutic intervention in DKA is appropriate fluid replacement followed by insulin administration. 0.9% sodium chloride solution (‘normal saline’) is the fluid resuscitation of choice according to the latest guidance from the Joint British Diabetes Societies.
10005377
b
IV Ringer's Lactate (Hartmann's solution)
QuestionChoice
This is an oral medication used in the treatment of type 2 diabetes mellitus.
10005380
e
Gliclazide
Concept
Chapter
2693
4394
Emergency Management of Diabetic Ketoacidosis
Topic
221
Endocrine
13622
A 26-year-old type 1 diabetic male presents to the emergency department by ambulance. His bedside glucose is 22mmol/L (nromal <6.1 mmol/L). His ketones are 3.8mmol/L (normal <0.6 mmol/L) and bicarbonate 14mmol/L (normal 22-30 mmol/L) on a venous blood gas.

Which of the following is the best next step in the management of this patient?
a