If given steroids, must be off cortisol 24 hrs 2. Order 0.25 mg cortrosyn from pharmacy and reconstitute. Draw baseline cortisol level. Wait 30 and 60 minutes and draw cortisol level at each time point. If you want to only do one draw, a 45 minute time point is considered acceptable by most endocrinologists.
Endocrinologists absolutely HATE sliding scales.
They are not meant to treat diabetes, but exist merely to prevent hypoglycemia. Watch for CHF, volume overload. Goal is to close the anion gap, not to reduce hyperglycemia. Patient may still be in DKA when anion gap closes if bicarb still low. Patient should be transferred to a unit for close observation and frequent labs.