Open Sim Lab
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Diabetic ketoacidosis

Educational use only. Not clinically reviewed

29-year-old woman for Emergency fluid, electrolyte, insulin, and transition pathway. About 10 simulated minutes.

What you will practise

  • Recognize DKA from diabetes or hyperglycemia, ketonemia, and metabolic acidosis while reviewing severity and precipitant.
  • Record initial isotonic fluid, monitoring, access, and serial laboratory intent.
  • Delay insulin while potassium is below 3.5 mmol/L and record replacement plus monitoring.
  • Record IV insulin only after the potassium gate, then add dextrose when glucose falls below 250 mg/dL while ketoacidosis persists.
  • Use plasma ketone and pH or bicarbonate criteria to confirm resolution, then record overlap and precipitant-safe transition.

Review and sources

Not clinically reviewed. No clinician has signed this scenario.

  • Umpierrez GE, et al. Hyperglycemic Crises in Adults With Diabetes: A Consensus Report. Diabetes Care. 2024;47(8):1257-1275. doi:10.2337/dci24-0032.
  • American Diabetes Association Professional Practice Committee. Diabetes Care in the Hospital: Standards of Care in Diabetes—2026. Diabetes Care. 2026;49(Suppl 1):S339-S363.

Every scenario in this module

Open Sim Lab is an educational simulator, not for clinical use. It is not a clinical decision-support tool, not a dosing calculator, and is not validated for any decision affecting a real patient.