A 26-year-old female with type 1 diabetes develops a sore throat and runny nose after caring for her sick toddler

Question

The patient calls the clinic for advice about her symptoms and a blood glucose level of 210 mg/dL despite taking her usual glargine (Lantus) and lispro (Humalog) insulin. The nurse advises the patient to
a. use only the lispro insulin until the symptoms are resolved.
b. limit intake of calories until the glucose is less than 120 mg/dL.
c. monitor blood glucose every 4 hours and notify the clinic if it continues to rise.
d. decrease intake of carbohydrates until glycosylated hemoglobin is less than 7%.

Answer 1

ANS: C
Infection and other stressors increase blood glucose levels and the patient will need to test blood glucose frequently, treat elevations appropriately with lispro insulin, and call the health care provider if glucose levels continue to be elevated. Discontinuing the glargine will contribute to hyperglycemia and may lead to diabetic ketoacidosis (DKA). Decreasing carbohydrate or caloric intake is not appropriate because the patient will need more calories when ill. Glycosylated hemoglobin testing is not used to evaluate short-term alterations in blood glucose.