#april2020mccqe1
A 52-year-old African-American woman with type 2 diabetes mellitus (DM) presents to her physician’s office and states that she has been “feeling lousy in the morning.” She notes that she reliably checks her blood glucose levels, and is frustrated at the fact that she often has a blood sugar level in the 120s at night, followed by a level in the 170s to 180s the following morning. The patient’s primary care physician increased her nightly dose of neutral protamine Hagedorn insulin 1 month ago, but her morning glucose levels have only become more elevated. She has recently begun to limit her carbohydrate intake at night, with no effect. This patient’s morning hyperglycemia might most likely be alleviated by which of the following?
(A) Decreasing neutral protamine Hagedorn insulin at night
(B) Increasing neutral protamine Hagedorn insulin at night
(C) Increasing neutral protamine Hagedorn insulin in the morning
(D) Increasing regular insulin at night
(E) Increasing regular insulin in the morning
A 52-year-old African-American woman with type 2 diabetes mellitus (DM) presents to her physician’s office and states that she has been “feeling lousy in the morning.” She notes that she reliably checks her blood glucose levels, and is frustrated at the fact that she often has a blood sugar level in the 120s at night, followed by a level in the 170s to 180s the following morning. The patient’s primary care physician increased her nightly dose of neutral protamine Hagedorn insulin 1 month ago, but her morning glucose levels have only become more elevated. She has recently begun to limit her carbohydrate intake at night, with no effect. This patient’s morning hyperglycemia might most likely be alleviated by which of the following?
(A) Decreasing neutral protamine Hagedorn insulin at night
(B) Increasing neutral protamine Hagedorn insulin at night
(C) Increasing neutral protamine Hagedorn insulin in the morning
(D) Increasing regular insulin at night
(E) Increasing regular insulin in the morning
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