Question

A 60-year-old man with Type 2 diabetes. He has had to take insulin for the past 2 years and normally takes a morning injection of both NPH and regular insulin. His nurse practitioner has told him that his late afternoon blood glucose readings are too high.

A. Which of his 2-morning insulins needs to be adjusted?

B. Will his insulin be increased or decreased?

C. Mr. Sweet knows that exercise will help his diabetes, but he doesn’t know why. What do you tell him?

D. You also want review BASIC diet rules with Mr. Sweet. What might that include?

Answer 1

A) His NPH insulin dose needs to be adjusted because Regular insulin is short acting where as NPH is a long acting insulin and it controls late evening blood sugars.

B) Since his late afternoon blood glucose readiings are too high, his insulin dose needs to be increased.

C) Exercise helps to control blood glucose levels, reduces cardiovascular risk factors, causes loss of weight and enhances well being in diabetic patients.

D)Diet rules :

- Reduce carbohydrate intake by reducing amounts of refined grains or added sugars in diet.

- Consume carbohydrates from seasonal fruits, green leafy vegetables, whole grains, pulses or no fat milk.

- Eat lean protein , high fiber content diet.

- Use healthy vegetable oils like olive oil.

- Avoid trans fats or saturated fats.