A 46-year-old woman with a 22-year history of type 1 diabetes mellitus presents to her endocrinologist for a routine follow-up, reporting episodes of nocturnal diaphoresis, palpitations, and morning headaches occurring three to four times per week over the past two months. Her current regimen includes a basal insulin with a pronounced overnight peak, which her endocrinologist suspects is responsible for her recurrent hypoglycemic episodes. Her fasting blood glucose this morning was 58 mg/dL, and her HbA1c is 6.2%, suggesting frequent unrecognized hypoglycemia. Vital signs are within normal limits, and her BMI is 23 kg/m². To minimize nocturnal hypoglycemia while maintaining adequate glycemic control, her endocrinologist switches her to a long-acting basal insulin analog that provides relatively steady 24-hour coverage with little to no pronounced peak. Which of the following was most likely prescribed?
- A)Regular insulin
- B)Insulin lispro
- C)NPH insulin
- D)Insulin glargineGABARITO
- E)Repaglinide
Explicação
Insulin glargine is a long acting basal insulin formulated to provide steady background insulin with minimal peak effect. This reduces the risk of nocturnal hypoglycemia compared with intermediate acting preparations such as NPH. Ver explicação completa e trilha adaptativa →