Diabetic ketoacidosis; IVF or IV Insulin First! - USMLE Forums
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Old 08-04-2013
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Question Diabetic ketoacidosis; IVF or IV Insulin First!

If in the options for Tx of DKA is given both

A. aggressive IVF with 0.9% normal saline
B. IV insulin

Which one should we choose ?
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  #2  
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Old 08-04-2013
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Is this a Uworld question?

I would pick A- aggressive fluids

I think i've read somewhere (either uworld or MTB 2) that fluids are even more important than insulin to immediately bring down glucose levels.. not 100% sure though.
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Quote:
Originally Posted by DrSK View Post
Is this a Uworld question?

I would pick A- aggressive fluids

I think i've read somewhere (either uworld or MTB 2) that fluids are even more important than insulin to immediately bring down glucose levels.. not 100% sure though.
I dont know i havent done uw yet
But i found inconsistencies between fischers comprehensive cases (IVF) and kaplan videos (IV insulin)

MTB mentions both as a single option
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Old 08-04-2013
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A. i guess the first step should be to restore intravascular volume
and correct the dehydration
next is to start insulin
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Originally Posted by MedicalExaminer View Post
If in the options for Tx of DKA is given both

A.aggressive IVF with 0.9% normal saline
B.IV insulin

Which one should we choose ?
I think A cuz this 'll save the pt then insulin .
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Quote:
Originally Posted by MedicalExaminer View Post
If in the options for Tx of DKA is given both

A.aggressive IVF with 0.9% normal saline
B.IV insulin

Which one should we choose ?
The problem with the patient eventho he has high glucose doesnt rely on that.. these patients have up to 10 Liters of fluid deficit.. You always start with aggressive hydration.

Also remember that you always start with ABC's in every emergency situation, DKA is one of them, insulin is not a part of the ABC's but liquids are..
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Old 08-07-2013
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Normal Saline is the best initial treatment
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Quote:
Originally Posted by MedicalExaminer View Post
If in the options for Tx of DKA is given both

A. aggressive IVF with 0.9% normal saline
B. IV insulin

Which one should we choose ?
A for purpose of that question, but you will start your insulin IV soon after starting fluids, and remember about potassium.
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Old 08-08-2013
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ABCs yo

circulation that itch!
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