60 year old woman with T2DM follow-up visit. Regimen: NPH 14 units QAM and 10 units QPM, and lispro 8 units TID AC Pre-prandial: SMBG 3x/day Date Breakfast Lunch Dinner Mon 270 120 90 Tue 246 128 110 Wed 260 118 118 Thurs 268 100 98 Fri 290 132 120 Sat 242 124 88 Sun 258 114 112 How would this patient be assessed, and what insulin adjustments are needed? 60 year old woman with T2DM follow-up visit. Regimen: NPH 14 units QAM and 10 units QPM, and lispro 8 units TID AC Pre-prandial: SMBG 3x/day Date Breakfast Lunch Dinner Mon 270 120 90 Tue 246 128 110 Wed 260 118 118 Thurs 268 100 98 Fri 290 132 120 Sat 242 124 88 Sun 258 114 112 How would this patient be assessed, and what insulin adjustments are needed? Uncontrolled morning values, fasting is elevated should be between 70-130 mg/dL; bolus affects FBG so would want to increase NPH morning dose, increase dose of QPM by 20 to 30%, this would be 11 to 12 units of NPH QAM Uncontrolled morning values, fasting is elevated should be between 70-130 mg/dL; basal affects FBG so would want to increase NPH