Which is a component of DKA treatment?

• A. Oral rehydration solutions only
• B. Bicarbonate for acidosis
• C. Insulin infusion phase only
• D. Water and electrolyte replacement

Answer: (D)

Restoring fluid volume and correcting electrolyte balance are the foundation of DKA treatment. When DKA occurs, heavy losses from dehydration and osmotic diuresis create significant fluid and electrolyte deficits. The initial priority is to replace those fluids and rebuild circulating volume with IV fluids, while also bringing electrolytes back toward normal, especially potassium, because total body potassium is depleted even if blood levels look normal or high at first. This fluid and electrolyte replacement sets the stage for subsequent steps like insulin therapy to address hyperglycemia and acidosis. Bicarbonate is not routinely used unless acidosis is extremely severe, and oral rehydration alone isn’t appropriate in the acute, IV-fluids-needed setting. Therefore, water and electrolyte replacement is a core component of DKA management.