qqqq - mumbai

[ArchivalUser]

A 15-year-old girl with type 1 diabetes mellitus is brought to her primary care doctor for a routine check up. Evaluation of her blood glucose chart indicates that her recorded blood glucose levels are routinely between 120 and 150 mg/dL before breakfast, dinner and bedtime, with the normal being 116 mg/dL. She is on NPH and regular insulin. She does well in school and plays on the school tennis team. Which of the following is the most appropriate step in management?
A. Decrease the dosage of NPH
B. Decrease the dosage of Regular insulin
C. Make no changes and obtain a glycosylated Hb test
D. Increase the dosage of NPH
E. Increase the dosage of Regular insulin

[ArchivalUser]

C no change

[ArchivalUser]

prepck,dont u think the pre meal glucose is on higher side,i mean 120-150,
hence why not go for more tight sugar control by increasing dose of NPH

[ArchivalUser]

I would go with C as well. The high morning glucose could be due to Down phenomenon or Sumogyi effect, so the Tx might be different. Also, theu don't give us the way she is taking insulin. Glycosylated Hb A1 will give you an idea about overall glucose controle in the past few weeks.
What is the correct answer?

[ArchivalUser]

Mumbai: her level is a good one 120 - 150 with ref 116.