Question

A patient with type 1 diabetes mellitus who is on NPH and regular insulin split-dosing presents with complaints of early morning rise in fingerstick blood glucose. A review of an at-home glucose test reveals increased morning levels. After an increase in the evening insulin dose, the problem worsens. This is most likely an example of____________________

Answer 1

The patient most likely experiences the Dawn Phenomenon, which is characterized by a rise in blood glucose levels in the early morning. This can happen when the regular insulin dose is not sufficient to cover the morning spike in glucose.

Step-by-step explanation:

Based on the provided information, it is most likely that the patient is experiencing what is known as the Dawn Phenomenon.

This phenomenon refers to the natural rise in blood glucose levels in the early morning hours, typically between 3 am and 8 am.

It occurs as a result of the body releasing hormones, such as cortisol, growth hormone, and glucagon, which increase insulin resistance and stimulate the liver to release stored glucose.

In individuals with type 1 diabetes who are on NPH and regular insulin split-dosing, the regular insulin is usually designed to cover the morning spike.

However, if the dose is not adequate, it can lead to persistently elevated blood glucose levels in the morning.