Placement Test: Fine-Tuning Basal Insulin

1) Which of the following represents typical basal insulin requirements in adults?

A. A steady peak through the night, followed by an afternoon drop.
B. An evening peak followed by a drop in the morning.
C. An early morning peak followed by a midday drop.
D. Relatively high levels through the day and lower levels at night.

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2) To properly test basal insulin overnight, which conditions must be met?

A. No exercise at all during the day.
B. No bolus insulin may be given at dinnertime.
C. No calories of any kind may be consumed after dinner.
D. All of the above.

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3) An overnight basal test produced the following blood sugar readings:

10PM – 195 mg/dl (10.9 mmol/l)
1AM – 193 mg/dl (10.8 mmol/l)
4AM – 162 mg/dl (9.0 mmol/l)
7AM – 124 mg/dl (6.9 mmol/l)

How would you interpret these results?

A. The basal insulin is set about right.
B. The basal insulin is set too high, especially in the middle of the night.
C. The basal insulin is too low since the glucose was elevated to start the test.
D. The basal insulin is too low in the early part of the night, and just right in the early morning.

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4) When adjusting basal rates on a pump, changes should be made:

A. When a pattern of highs or lows occur after a certain meal.
B. Any time blood sugars remain elevated for an extended period of time.
C. When blood sugar begins to rise or fall during a fasting test.
D. 1-2 hours before blood sugars start to rise or fall during a fasting test.

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5) Temporary basal adjustments can be useful during:

A. Short, intense bouts of exercise.
B. Consumption of very high-carb meals.
C. Sudden bouts of stress, like surprise tests.
D. Prolonged bouts of exercise.

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So How did you do?