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USMLE Step 1 Year: 2024 Number: 0629 

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A 57-year-old female obese patient has Type II (noninsulindependent) diabetes mellitus of 15 years duration. Because her hyperglycemia is not well controlled with diet and oral hypoglycemic agents, she selfadministers insulin by injection. She comes to her physician’s office with a fever and a draining external ear infection; Pseudomonas aeruginosa is cultured from the drainage fluid. Which of the following insulin regimens most closely mimics insulin release from a normally functioning pancreas?
post-meal injection of lente insulin plus a prebreakfast injection of regular insulin
Post-meal injections of insulin glargine
prebreakfast and predinner injections of lente insulin plus an injection of regular insulin if blood glucose (measured by finger-stick) exceeds 150 mg/dL
premeal injections of insulin lispro plus morning and evening injections of detemir insulin
premeal injections of NPH insulin plus an injection of insulin lispro at bedtime

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10 апр 2024

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