In the scenario with a patient taking regular and NPH insulin given at 0730, when is the next injection likely required?

In the scenario with a patient taking regular and NPH insulin given at 0730, when is the next injection likely required?

• A. Noon
• B. Bedtime
• C. Mid-morning
• D. Mid-afternoon

Answer: (B)

When regular insulin and NPH are given together in the morning, the regular (short-acting) component acts quickly for meals but wears off in about 6–8 hours, while the NPH (intermediate-acting) starts later and provides coverage into the afternoon, evening, and overnight. By bedtime, the morning regular has waned, and the overnight period needs insulin action to maintain glucose control. A dose at bedtime reestablishes both rapid-acting coverage for the evening meal (with the regular portion) and long-acting basal coverage (with the NPH portion) for the night. That’s why the next injection is typically at bedtime.

When regular insulin and NPH are given together in the morning, the regular (short-acting) component acts quickly for meals but wears off in about 6–8 hours, while the NPH (intermediate-acting) starts later and provides coverage into the afternoon, evening, and overnight. By bedtime, the morning regular has waned, and the overnight period needs insulin action to maintain glucose control. A dose at bedtime reestablishes both rapid-acting coverage for the evening meal (with the regular portion) and long-acting basal coverage (with the NPH portion) for the night. That’s why the next injection is typically at bedtime.