Clinical Case 10

Clinical Case 10

Clinical Case 10
(See related pages)

1

A 22-year-old man (BMI 22 kg/M2) with type 1 diabetes mellitus is treated with the following insulin regimen: Before breakfast- 8U R and 20U NPH, Before supper- 4U R, At bedtime- 12U NPH. His blood glucose values (in mg/dL) are as follows:

Day	Before Breakfast	Before Lunch	Before Supper	Before Bedtime
1	86	104	96	320
2	146	123	105	296
3	111	97	92	341

Which of the following is the most appropriate intervention to improve his glycemic control?

A)

Increase morning NPH dose and add Regular insulin to bedtime dose of NPH.

B)

Make no changes in insulin administration; reduce caloric intake at evening meal

C)

Increase dose of Regular insulin at evening meal.

D)

Discard current insulin regimen and change to 3 injections of regular insulin before meals. Change evening injection to ultralente.

E)

No change in insulin regimen is required, as overall control is good.

Notes

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Home > 14. Endocrin. & Metab. > Clincal Case 10