A young man presents with diabetic ketoacidosis. What is the immediate management required?

The correct response emphasizes that the primary components in the immediate management of diabetic ketoacidosis (DKA) are the administration of intravenous fluids and continuous insulin infusion.

In DKA, the patient experiences a severe deficit in fluids and electrolytes due to osmotic diuresis, and the presence of ketones leads to metabolic acidosis. Therefore, the immediate goal is to restore the intravascular volume with fluids while simultaneously lowering the blood glucose levels and correcting the ketosis.

Intravenous fluids help to rehydrate the patient, improve perfusion, and dilute the high glucose levels, while continuous insulin infusion is crucial for throttling down the hyperglycemia and halting the production of ketone bodies. This combination addresses the critical needs of the patient in a timely manner, preventing the progression of complications associated with DKA.

Other options such as intravenous dextrose are counterproductive in acute DKA management as they can exacerbate hyperglycemia. A bolus of intravenous insulin may not provide sustained glucose control, and subcutaneous insulin is not appropriate in the acute setting of DKA, where immediate action is necessary to stabilize the patient.