Endocrine Pharmacology USMLE Step 1 Practice Question
A 46-year-old woman with a 22-year history of type 1 diabetes mellitus presents to her endocrinologist reporting episodes of waking up diaphoretic and confused at approximately 2–3 AM on most nights over the past three weeks. Her current regimen includes NPH insulin at bedtime, which she has used for several years. Her HbA1c is 7.8%, fasting glucose this morning was 68 mg/dL, and her continuous glucose monitor log confirms glucose nadirs consistently occurring between midnight and 4 AM. Her BMI is 24 kg/m², blood pressure is 118/74 mmHg, and physical examination is unremarkable. Her endocrinologist decides to switch her to a basal insulin preparation that provides relatively steady 24-hour insulin coverage with little to no pronounced peak, thereby minimizing the risk of nocturnal hypoglycemia. Which of the following was most likely prescribed?
Answer choices
- AInsulin glargineCorrect answer
- BRegular insulin
- CRepaglinide
- DInsulin lispro
- ENPH insulin
- FInsulin detemir
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