If a patient is on the DKA fluid regime and also sliding scale and is nil by mouth, if that patient were to go into a hypo that did not improve when the iv insulin stopped, would you still give the standard acute treatment of 20% iv glucose until out of the hypo? Would it make a difference that the patient is being treated for DKA or would your main priority be to take the patient out of the hypo?
Feb 8, '17
What do you think the treatment priorities should be?
And do you think that the insulin infusion should be stopped?
May 5, '17
If any patient experiences hypoglycemia symptoms then yes you treat it. What is the reason we give IV insulin and all those fluids for the DKA patient?? Hint: the main reason is not to lower their glucose (although ultimately that is what we are doing). The main purpose is to get them out of the acidosis.
So, if you have a patient who suddenly drops their glucose and is symptomatic, treat them. Turn off the gtt, notify the doc, give them IV dextrose for severe hypoglycemia or some glucose tabs if it's just minor. Keep the fluids running.