🏥 USMLE Exam Prep

A 60-year-old male with type 2 diabetes presents with polyuria, polydipsia, and significant weight loss over several weeks. His blood glucose is 550 mg/dL, and A1c is 10.5%. Urinalysis shows 2+ ketones. Which is the most appropriate initial management strategy for this patient?

A Start oral metformin and lifestyle modifications
B Initiate intravenous regular insulin infusion
C Prescribe a glipizide and monitor glucose levels
D Administer subcutaneous long-acting insulin once daily

✓ Correct Answer: Option B

The patient exhibits symptoms of severe hyperglycemia with ketonuria, consistent with new-onset or poorly controlled diabetes possibly complicated by mild DKA or ketosis. Intravenous regular insulin is crucial for rapid and controlled glucose reduction in such severe cases.

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