Interactive diabetes case 1: Inpatient management in type 1 diabetes – A1

ANSWER — 

Incorrect.

Your order is implemented.

The 11:30 AM blood glucose level is 467 mg/dL (26 mmol/L).

The use of a sliding scale insulin regimen as the sole treatment of hyperglycemia in inpatients with insulin-treated diabetes at home is strongly discouraged [1].

You order which of the following?

●Treatment for diabetic ketoacidosis (DKA) with an intravenous bolus of regular insulin 10 units, an insulin infusion at 0.1 unit/kg/hour, and normal saline at 500 cc/hour. (See "Interactive diabetes case 1: Inpatient management in type 1 diabetes – B1".)

●NPH insulin 8 units and regular insulin 12 units subcutaneously and a serum beta-hydroxybutyrate level to exclude DKA. (See "Interactive diabetes case 1: Inpatient management in type 1 diabetes – B2".)

●Regular insulin 12 units as per the sliding scale regimen and a serum beta-hydroxybutyrate level to exclude DKA. (See "Interactive diabetes case 1: Inpatient management in type 1 diabetes – B3".)