Endocrine Pharmacology USMLE Step 1 Practice Question
A 27-year-old woman with a 10-year history of type 1 diabetes mellitus presents for a routine follow-up appointment. She uses a basal-bolus insulin regimen with insulin glargine at bedtime and reports that her fasting glucose values are consistently within her target range of 80–110 mg/dL. However, she notices sharp postprandial glucose spikes reaching 280–320 mg/dL approximately 1 hour after meals. Her HbA1c is 8.4%, and her BMI is 22 kg/m². Physical examination is unremarkable, and her blood pressure is 118/74 mmHg. To address her postprandial hyperglycemia, her physician prescribes an insulin analog engineered with reversed amino acids at positions B28 and B29, which prevents hexamer formation, allowing for the fastest subcutaneous onset and shortest duration of action among available insulin preparations. Which of the following drugs was most likely prescribed?
Answer choices
- AInsulin degludec
- BInsulin glargine
- CInsulin lisproCorrect answer
- DNPH insulin
- ERegular insulin
- FInsulin glulisine
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