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JM is a 32-year-old women who comes to your diabetic clinic with complain of several episodes of hypoglycemi
a. She is on Insulin NPH/regular 70/30, 22 units twice a day with breakfast and dinner. 8 units with lunch.
After discussing with physician you decide to decrease the total daily insulin by 10% and change to insulin glargine once a day and Insulin Lispro three time a day at ratio of 50:50 -- 50 % of long and 50 % of short acting insulin.
What is her new insulin regimen? Round down to the nearest 1 unit.
Suggested Answer: C
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22 2 + 7 = 51 units of total insulin per day. Decrease by 10% 51 units 0.9 = 45.9 units per day round up to 46 units. 46 units 0.50 = 23 units, administer 23 units of insulin glargine once daily. 46 units 0.50 = 23 units total Insulin Lispro. Round down, divided by three times a day, 7 units 3 times a day with meals.
32 comments · newest first
SE
Serina
6 months ago
E is a bit off. I’d stick with A or B for safety.
GA
Gayla
6 months ago
I’m leaning towards B too. 15 units is a good reduction.
LI
Linwood
6 months ago
D is definitely too much insulin. A or B makes more sense.
VE
Venita
6 months ago
C seems too high for glargine. I’d go with A.
SO
Socorro
6 months ago
I feel like B is the best choice. 15 units sounds right.
HA
Hannah
7 months ago
I’m surprised they’re switching to glargine; it’s a big change!
DE
Deandrea
7 months ago
Definitely not D, that’s way too high!
AR
Art
7 months ago
B) 15 units of insulin glargine once daily, Insulin Lispro 5 units 3 times a day with meals. Sounds like a good compromise between the long and short-acting insulin.
LO
Louann
8 months ago
D) 30 units of insulin glargine once daily, Insulin Lispro 6 units 3 times a day with meals. Wait, is that too much insulin? I'm so confused.
RO
Roslyn
8 months ago
This question is making my head spin. I'll just go with C) and hope for the best.
DO
Donette
8 months ago
E) 18 units of insulin glargine once daily, Insulin Lispro 6 units 3 times a day with meals. Yep, that's the one.
QU
Quinn
8 months ago
A) 16 units of insulin glargine once daily, Insulin Lispro 4 units 3 times a day with meals. Looks good, but I'd round up to the nearest unit just to be safe.
LA
Lavera
8 months ago
B) 15 units of insulin glargine once daily, Insulin Lispro 5 units 3 times a day with meals. Seems like the right answer to me.
LE
Leonida
8 months ago
I feel like option B makes sense since it seems to balance the long and short-acting insulin, but I'm not entirely confident about the numbers.
FR
France
9 months ago
I practiced a similar question where we had to switch from NPH to glargine, but I can't recall the exact ratios we used for Lispro.
CO
Cory
9 months ago
I think the total daily insulin was 62 units before the change, so 10% would be about 6 units, right?
GE
German
9 months ago
I remember we talked about reducing the total daily insulin by 10%, but I'm not sure how to calculate that exactly.
LA
Lai
9 months ago
Okay, I think I've got a good strategy. I'll break this down into smaller steps, calculate the new total daily insulin, and then divide it up accordingly. Gotta stay focused and double-check my work.
KI
Kimberlie
9 months ago
Whoa, this is a lot of information to process. I better read through it carefully and make sure I understand all the details before I start calculating. Don't want to make any silly mistakes.
LO
Louvenia
9 months ago
Alright, I've got this. I just need to do the math step-by-step and make sure I'm rounding down to the nearest unit. I feel confident I can get the right answer.
CH
Christa
10 months ago
I think the answer is A. It seems reasonable.
BL
Blair
10 months ago
Wait, how did we get to 16 units for glargine? Seems off.
MU
Muriel
10 months ago
JM's total daily insulin was 66 units before the reduction.
TU
Tula
10 months ago
I think option A looks right based on the calculations!
FL
Flo
10 months ago
This question is a real insulin-ator. I'm going with E) just to see if I can get lucky.
LE
Lenna
11 months ago
Okay, let's see. I need to figure out the total daily insulin and then split it into the long-acting and short-acting components. This will take some thinking, but I think I can work it out.
LA
Lawrence
11 months ago
Hmm, this looks like a tricky one. I'll need to carefully calculate the new insulin regimen based on the 10% decrease and the 50:50 ratio.
AL
Alyce
4 months ago
Then split that 50:50 for glargine and lispro!
EL
Eliz
5 months ago
That brings us to 47 units total.
IZ
Izetta
5 months ago
So, a 10% decrease would be 5.2 units, rounded down to 5.
ME
Melvin
5 months ago
Right! 22 + 22 + 8 equals 52 units total.
BU
Buck
6 months ago
I think we need to start with the total daily insulin.