A patient with newly diagnosed type 1 diabetes is being transitioned from an infusion of intravenous (IV) regular insulin to an intensive insulin therapy regimen of insulin glargine (Lantus) and insulin aspart (NovoLog)
How should the nurse manage this transition in insulin delivery? a. Administer the insulin glargine and continue the IV insulin infusion for 24 hours.
b. Administer the insulin glargine and discontinue the IV infusion in several hours.
c. Discontinue the IV infusion and administer the insulin aspart with the next meal.
d. Discontinue the IV infusion and administer the Lantus insulin at bedtime.
B
Subcutaneous insulin should be administered 1 to 4 hours before discontinuing the intravenous infusion to allow the patient to reach adequate plasma insulin levels to prevent redevelopment of DKA. Continuation of the insulin infusion in conjunction with the long-acting insulin glargine would result in hypoglycemia. Discontinuation of intravenous insulin prior to administration of subcutaneous insulin would result in reoccurrence of DKA in a patient with type 1 diabetes.
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