Endocrine Pharmacology USMLE Step 1 Practice Question
A 27-year-old woman with a 12-year history of type 1 diabetes mellitus presents to her endocrinologist for a routine follow-up. She currently uses a basal bolus insulin regimen with insulin glargine at bedtime and regular insulin before meals. Her fasting glucose values have been well-controlled, averaging 95–105 mg/dL, but she reports consistent postprandial glucose spikes to 280–320 mg/dL occurring approximately 30–60 minutes after eating. Her hemoglobin A1c is 8.4%, and her BMI is 22 kg/m². Vital signs are within normal limits. Physical examination reveals no lipodystrophy at injection sites. Her physician decides to switch her mealtime insulin to a preparation with a faster onset and shorter duration of action that should be injected immediately before eating. Which of the following drugs was most likely prescribed?
Answer choices
- ARegular insulin
- BNPH insulin
- CInsulin glargine
- DInsulin degludec
- EInsulin lisproCorrect answer
- FInsulin glulisine
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