A 7-year-old with type 1 diabetes presents in diabetic ketoacidosis with pH 7.1. Why are rapid large fluid boluses avoided unless he is shocked?
Answer and explanation
Correct answer: C. Rapid fluids increase the risk of cerebral oedema
- Step 1: Cerebral oedema is the most serious complication of DKA in children.
- Step 2: British Society for Paediatric Endocrinology and Diabetes guidance replaces fluid deficit slowly over 48 hours.
Answer
Rapid fluids increase the risk of cerebral oedema.
Why not the others: They cause immediate renal failure by overloading the kidneys with sodium: Renal failure is not an immediate result. They always cause severe hypoglycaemia by diluting circulating insulin levels: Hypoglycaemia is not the mechanism. They interfere with the absorption of subcutaneous insulin into the circulation: Insulin is given intravenously, not absorbed through tissue.
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