A T1DM man, who is on Glargine at bedtime and Aspart insulin three times a day with each meal, has a persistent elevation of his 6am blood glucose. What will be the appropriate action?
سؤال مجاني 3 من 10 اليوم · اشترك وكمّل بدون حد
اعرض الإجابة
الإجابة والشرح
ادخل لحسابك عشان نحفظ إجاباتك ونوريك أخطاءك.
المصادر مختلفة. ملفات الدفعة فيها إجابتين، وما نرجّح وحدة على الثانية. سبب كل وحدة في الشرح تحت:
- إجابة: D. Check 3 am blood glucose level
- إجابة ثانية: A. Increase night long-acting insulin (Glargine)
Persistent fasting (6 am) hyperglycemia on basal-bolus insulin may be the dawn phenomenon or the Somogyi effect. The cohort's endocrine summary says to check 3 am glucose: high = dawn (increase evening insulin), low = Somogyi (decrease it). So D is the expected exam answer.
- However, Step-Up states the Somogyi effect has been refuted, and the RT slides say glargine is monitored by the early-morning reading. That supports simply up-titrating glargine (A), so be aware of both.
ليش كل خيار صح أو غلط
-
A
ليش صح
Supported by the RT slides: glargine is a single bedtime dose that controls nocturnal glucose, monitored by the early-morning reading. (The endocrine summary supports D.)
✓ RT - DM.pdf · p. 5 -
B
ليش غلط
Short-acting insulin works around meals; the 6 am value reflects overnight glucose, which the bedtime basal insulin controls.
✓ RT - DM.pdf · p. 5 -
C
ليش غلط
Evening aspart is a rapid-acting mealtime insulin (5-15 min before meals); it is not the insulin that controls overnight glucose.
✓ RT - DM.pdf · p. 5 -
D
ليش صح
Supported by the endocrine summary: for morning hyperglycaemia, check the 3 am glucose first (high = dawn phenomenon, low = Somogyi effect). The RT slides support A.
✓ Endocrine ✳️.pdf · p. 4
- المصدر
- Endocrine ✳️.pdf · p. 4
RT - DM.pdf · p. 5
Step Up To Medicine 6th Edition 2024 (DM).pdf · p. 3 - المحاضرة
- Diabetes Mellitus · Endocrinology · Module B
- ظهر في
- Endo bank