What treatment should accompany thiamine for a patient with alcoholic ketoacidosis?

In the context of treating alcoholic ketoacidosis, thiamine supplementation is critical to prevent Wernicke's encephalopathy, a potential complication of alcohol misuse. However, the management of alcoholic ketoacidosis also requires addressing the metabolic derangements present in the patient.

Administering normal saline and glucose is beneficial because it helps to correct dehydration and replenish electrolyte imbalances. The provision of glucose is essential, as it aids in suppressing ketogenesis; when the body receives adequate glucose, it reduces the production of ketones, which is particularly relevant in ketoacidosis. Therefore, alongside thiamine, normal saline and glucose together work to stabilize the patient's condition by rehydrating and providing an adequate carbohydrate source.

In contrast, the other treatments listed may not specifically address the immediate needs associated with alcoholic ketoacidosis or might not be effective in promoting the proper metabolic recovery. For instance, insulin could theoretically help manage blood glucose levels, but in the context of ketoacidosis, the focus should initially be on hydration and glucose rather than insulin administration. Similarly, while intravenous dextrose does provide glucose, it is typically given in the form of a concentrated solution, while normal saline can be administered more effectively to manage fluid status. Beta-blockers