Endocrine Pharmacology USMLE Step 1 Practice Question
A 58-year-old man with a 12-year history of type 2 diabetes mellitus presents to his primary care physician reporting recurrent episodes of diaphoresis, tremulousness, and confusion occurring between 4:00 and 6:00 PM over the past two weeks. He takes a single subcutaneous insulin injection each morning at 7:00 AM and consistently eats lunch at noon. His fingerstick glucose during one episode measured 48 mg/dL, and symptoms resolved promptly after ingesting orange juice. His BMI is 31 kg/mĀ², blood pressure is 128/82 mmHg, and his most recent HbA1c is 7.1%. His current insulin formulation appears cloudy in the vial, has an intermediate duration of action, and produces a pronounced pharmacodynamic peak approximately 6 to 8 hours after administration. Which of the following drugs is most likely responsible?
Answer choices
- AInsulin lispro
- BRegular insulin
- CNPH insulinCorrect answer
- DInsulin degludec
- EInsulin glargine
- FInsulin detemir
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