Question

The physician has prescribed NPH insulin for a client with diabetes mellitus. Which statement indicates that the client knows when the peak action of the insulin occurs? A. "I will make sure I eat breakfast within 2 hours of taking my insulin." B. "I will need to carry candy or some form of sugar with me all the time." C. "I will eat a snack around three o'clock each afternoon." D. "I can save my dessert from supper for a bedtime snack."

Short answer

A. "I will make sure I eat breakfast within 2 hours of taking my insulin." B. "I will need to carry candy or some form of sugar with me all the time." C. "I will eat a snack around three o'clock each afternoon." D. "I can save my dessert from supper for a bedtime snack." Answer: C. "I will eat a snack around three o'clock each afternoon."

Step-by-step solution

Background knowledge about NPH insulin

NPH insulin (Neutral Protamine Hagedorn) is an intermediate-acting insulin used for managing diabetes mellitus. This insulin type is typically taken once or twice daily and has a slower onset than rapid-acting insulins. The peak action of NPH insulin usually occurs around 4-12 hours after being taken.

Analyze the answer choices

A. "I will make sure I eat breakfast within 2 hours of taking my insulin." - This statement suggests that the person knows that NPH insulin is not a rapid-acting insulin. However, it does not show a clear understanding of the peak action time. B. "I will need to carry candy or some form of sugar with me all the time." - Keeping sugar available is always a good idea for people with diabetes to manage hypoglycemia. However, this statement does not demonstrate an understanding of the peak action of NPH insulin. C. "I will eat a snack around three o'clock each afternoon." - This answer choice is more indicative of the peak action of NPH insulin. If the user were to take their NPH insulin in the morning, eating a snack around 3 pm would help to prevent hypoglycemia during the peak action. D. "I can save my dessert from supper for a bedtime snack." - This statement does not show an understanding of the peak action of NPH insulin. While having a snack before bedtime might be helpful, this does not address the specific timing of the peak action.

Select the correct answer

Based on the analysis of each answer choice, we can conclude that option C, "I will eat a snack around three o'clock each afternoon." demonstrates the best understanding of when the peak action of the NPH insulin occurs.

Key concepts

Diabetes Mellitus Management

Managing diabetes mellitus involves a careful balance of medication, diet, and exercise to maintain blood glucose levels within a target range.

For individuals using insulin therapy, understanding how different insulin types work is crucial for effective diabetes management. NPH insulin (Neutral Protamine Hagedorn) is an intermediate-acting insulin commonly used in the treatment plan. It is often administered once or twice a day to provide basal glucose control.

Unlike rapid-acting insulin, which is taken just before a meal to manage postprandial blood glucose spikes, NPH insulin works over a longer period and has a 'peak action' time. This is the period when the insulin is most actively lowering blood glucose and where monitoring is essential to avoid potential hypoglycemia.

To manage their condition effectively, patients must learn to anticipate and adjust their insulin doses, coordinate meal and snack times, and monitor blood glucose levels regularly. This knowledge helps in preventing fluctuations that can lead to hypo- or hyperglycemia, both of which can have severe health implications.

NPH Insulin Timing

The timing of NPH insulin is a critical component of diabetes self-care. After injection, NPH insulin typically begins to work within one to two hours, with a peak action occurring approximately 4 to 12 hours later. For individuals who inject NPH insulin in the morning, the peak action window often falls in the midafternoon to early evening.

Since the peak action correlates with an increased risk of hypoglycemia, it's important for patients to plan their meals and snacks accordingly. Consuming a snack or a meal during the peak action time can help stabilize blood glucose levels and prevent a sudden drop. Additionally, understanding the duration of the insulin's activity, which can last up to 18 hours, is important to avoid overlapping doses, which might increase the risk of hypoglycemia.

Correct timing of the insulin injections, relative to meals, activities, and monitoring glucose levels, can make a significant difference in the overall glycemic control for individuals with diabetes.

Preventing Hypoglycemia

Hypoglycemia, or low blood sugar, can occur when there is too much insulin for the amount of glucose in the bloodstream. This can lead to symptoms such as shaking, sweating, dizziness, confusion, and in severe cases, unconsciousness or seizures.

Preventing hypoglycemia is an essential part of diabetes management, especially for insulin users. Individuals can reduce the risk of hypoglycemia by:

• Eating regular meals and snacks with a good balance of carbohydrates, protein, and fats.
• Monitoring blood glucose levels frequently, especially before and after meals, and during the peak action of insulin.
• Adjusting insulin doses based on activity levels and carbohydrate intake.
• Having sources of quick-acting sugar (like candy or glucose tablets) readily available to treat low blood sugars immediately.

Education on the warning signs of hypoglycemia and how to treat it is also vital. Creating a 'hypoglycemia action plan' is a good strategy for patients to manage such episodes promptly and effectively.