Basal Insulin Case 2

CE / CME

The Role of Basal Insulin in the Modern Era of Diabetes Management: Interactive Case Challenge 2

ABIM MOC: maximum of 0.75 Medical Knowledge MOC point

Physician Assistants/Physician Associates: 0.75 AAPA Category 1 CME credit

Nurses: 0.75 Nursing contact hour

Physicians: maximum of 0.75 AMA PRA Category 1 Credit

Released: October 26, 2023

Expiration: October 25, 2024

Steven V. Edelman
Steven V. Edelman, MD

Activity

Progress
1
Course Completed

Follow-up—Case Continued
The patient continues to titrate degludec per instructions to reach an FBG target of <130 mg/dL. At her 1-month follow-up, the patient reports taking degludec 38 units at bedtime in addition to her other medications. Her FBG has decreased to 133 mg/dL, with a TIR of 68%, a TAR of 27%, and a TBR of 5%. She reports symptoms of hypoglycemia at various times throughout the day, typically once per week. She is unsure of the cause but thinks it is related to missed or delayed meals. She typically treats with a snack or meal. 

Question 3

Which of the following additional interventions would be best for this patient at this time to reduce the risk of hypoglycemia?