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Diabetes
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Problema 1
Problema 2
Problema 3
Problema 4
Problema 5
Problema 6
Problema 7
Problema 8
Problema 9
Problema 10
Diabetes
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4. Carbohydrates / Diabetes / Problema 4
Problema 4
A 16-year-old with weight loss, polyuria, polydipsia, and positive pancreatic autoantibodies arrives with blood glucose 420 mg/dL and ketonuria. Which is the immediate appropriate management and rationale?
A
Start an SGLT2 inhibitor immediately because they are the safest agents in patients with ketonuria and eliminate the need for insulin in type 1 diabetes.
B
Urgent initiation of intravenous insulin and fluid resuscitation because this presentation indicates type 1 diabetes with ketoacidosis risk requiring insulin to suppress ketogenesis and correct hyperglycemia.
C
Advise high-carbohydrate diet to combat weight loss and postpone pharmacotherapy as the condition will self-correct in weeks without intervention.
D
Begin metformin and schedule outpatient follow-up because oral agents are first-line for all adolescents with hyperglycemia including those with ketosis.
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