In DKA management with IV insulin, how often should blood glucose be checked?

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Multiple Choice

In DKA management with IV insulin, how often should blood glucose be checked?

Explanation:
Frequent blood glucose checks are essential when using IV insulin in DKA because the insulin drip can rapidly lower glucose and shift electrolytes and ketones. Checking every hour allows you to precisely titrate the insulin rate to steadily correct hyperglycemia while avoiding hypoglycemia, and to respond quickly if glucose drops or ketogenesis changes. As glucose approaches about 200–250 mg/dL, you’ll often switch to dextrose-containing fluids and continue careful monitoring to complete the resolution of ketoacidosis and transition to subcutaneous insulin, but the hourly check remains the standard during IV insulin therapy. Checking only every 4 hours, daily, or weekly would miss rapid fluctuations and pose safety risks.

Frequent blood glucose checks are essential when using IV insulin in DKA because the insulin drip can rapidly lower glucose and shift electrolytes and ketones. Checking every hour allows you to precisely titrate the insulin rate to steadily correct hyperglycemia while avoiding hypoglycemia, and to respond quickly if glucose drops or ketogenesis changes. As glucose approaches about 200–250 mg/dL, you’ll often switch to dextrose-containing fluids and continue careful monitoring to complete the resolution of ketoacidosis and transition to subcutaneous insulin, but the hourly check remains the standard during IV insulin therapy. Checking only every 4 hours, daily, or weekly would miss rapid fluctuations and pose safety risks.

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