Interactive diabetes case 13: Deterioration of glycemia in a 59-year-old patient with type 2 diabetes complicated by retinopathy, nephropathy, and neuropathy – A3

ANSWER — 

Incorrect.

The patient experiences increased variability of blood glucose levels, with alternating hyperglycemia and hypoglycemia.

A traditional insulin sliding scale is often not effective for glycemic management, even when added to a basal insulin dose. It does not take into account the patient's carbohydrate intake. The doses used are often insufficient to manage hyperglycemia. Insulin coverage typically begins at a high glucose value (eg, 201 mg/dL [11.2 mmol/L]), and the increments are often insufficient to correct greater degrees of hyperglycemia. A sliding scale is not a substitute for addressing other issues in a patient with diabetes.

Return to the beginning to try again. (See "Interactive diabetes case 13: Deterioration of glycemia in a 59-year-old patient with type 2 diabetes complicated by retinopathy, nephropathy, and neuropathy".)