Question of the Week | June 30, 2020

AJ is admitted to the hospital for the second time this month for DKA.  The 28-year-old has type 1 diabetes, wears a CGM, and uses insulin pen injections. AJs last A1c was 11.3%.  AJs admitting glucose is 498 mg/dl, his pH is 7.05, and is anion gap is above 12. 

What are the next steps?

  1. Give AJ 20 units of rapid-acting insulin IV push.
  2. Start IV fluids and evaluate electrolytes before starting IV insulin.
  3. Start IV insulin at 0.5 units/kg/hour.
  4. Initiate basal-bolus insulin.

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Hospital and Hyperglycemia |
Standards of Care Intensive 2020
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Recent research has demonstrated the importance of glucose control during hospitalization to improve outcomes not only in the inpatient setting but after discharge. This course reviews the evidence that supports inpatient glucose control and outlines practical strategies to achieve targets in the inpatient setting.  We provide templates of subcutaneous and insulin drip order sets. Join us to learn the latest in managing hyperglycemia in the hospital.

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