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JK is a 19-year-old male college student with T1DM. He stays away from home and does not follow a proper diet. His school schedule is erratic; therefore, he eats throughout the day. Currently, he takes extended long-acting analogue insulin once per day. By 8 P.M., his blood sugar levels start dropping to a very low value. Also, biochemical analysis shows trace amount of ketones in his blood.
Height: 5'10" Weight: 175 pounds Hemoglobin A1C: 9%
What is the most likely cause of JK's low blood sugar at 8 P.M.?
A. His insulin dose is too high.
B. He is eating too much.
C. He is exercising too much.
D. He is not exercising enough.
E. The timing and peak of his insulin do not match his intake.
Answer: E
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