Question

A patient has recently been started on Novolin 70/30 insulin 20 U in the morning and 10 U in the evening for Type 2 DM. The nurse tells the patient to have a snack in the car in case of hypoglycemia. Which of the following times in this patient most likely to experience hypoglycemia from the intermediate acting insulin?

Option 1: In the late afternoon
Option 2: Early in the morning
Option 3: Late at night
Option 4: During lunchtime

Answer 1

The patient is most likely to experience hypoglycemia in the late afternoon due to the peak activity of the intermediate-acting insulin from the morning dose of Novolin 70/30.

Step-by-step explanation:

When considering the administration of Novolin 70/30, a premixed insulin consisting of 70% NPH, an intermediate-acting insulin, and 30% regular insulin, a short-acting insulin, it is important to understand the pharmacokinetics to predict when hypoglycemia is most likely to occur. In this patient's case, hypoglycemia is most likely in the late afternoon (Option 1) due to the peak activity of the intermediate-acting component of the insulin mixture.

This peak usually occurs several hours after injection, which corresponds with the late afternoon timeline considering a morning dose. It is notable that hypoglycemia is a potential side effect of insulin therapy and that having a snack on hand can help quickly raise blood glucose levels if necessary.