A 15 year old girl with type 1 diabetes is brought to emergency complaining of dizziness. Laboratory findings include severe hyperglycemia, ketoacidosis and blood pH of 7.15. To achieve rapid control of severe ketoacidosis, appropriate drug is:
**Core Concept**
Type 1 diabetes is a metabolic disorder characterized by absolute insulin deficiency, leading to hyperglycemia, ketoacidosis, and potentially life-threatening complications. Severe ketoacidosis, indicated by a low blood pH, requires immediate intervention to restore metabolic balance.
**Why the Correct Answer is Right**
In severe ketoacidosis, the primary goal is to restore metabolic balance by reducing ketone production and promoting glucose utilization. Insulin therapy is the cornerstone of treatment, but in the acute setting, it may not be effective due to insulin resistance. However, administering **intravenous sodium bicarbonate** can help correct acidosis by buffering excess hydrogen ions, thereby improving pH and reducing the severity of ketoacidosis. This allows for more effective insulin therapy and promotes glucose utilization.
**Why Each Wrong Option is Incorrect**
**Option A:** This option is incorrect because it does not address the underlying metabolic imbalance in ketoacidosis.
**Option B:** This option is incorrect because, while insulin is essential for glucose control, it may not be effective in the acute setting due to insulin resistance.
**Option C:** This option is incorrect because, although it may help manage symptoms, it does not address the underlying metabolic imbalance in ketoacidosis.
**Clinical Pearl / High-Yield Fact**
In the management of diabetic ketoacidosis, it is essential to remember that insulin therapy should be initiated early, but in the acute setting, sodium bicarbonate may be necessary to correct acidosis and improve metabolic balance.
**Correct Answer:** C. Sodium bicarbonate