Basal Insulin Case 1

CE / CME

The Role of Basal Insulin in the Modern Era of Diabetes Management: Interactive Case Challenge 1

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

Richard E. Pratley
Richard E. Pratley, MD

Activity

Progress
1
Course Completed

Follow-up – Case Continued 
The patient continues to titrate glargine per instructions to reach an FBG target of <130 mg/dL. At her 1-month follow-up, the patient reports taking 32 units of glargine at bedtime in addition to her other medications. Her FBG average has decreased to 125 mg/dL, with a bedtime glucose average of 140 mg/dL. She reports symptoms of hypoglycemia at various times throughout the day, typically once a week. She is unsure of the cause but thinks it may be related to missed or delayed meals. She has not verified these symptoms with blood glucose monitoring and typically treats with a snack. Her weight remains consistent with the previous visit.

Question 3

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