Certified Diabetes Care and Education Specialist (CDCES) Practice Exam

What is the appropriate weight-based insulin dose recommendation for a 63-year-old man with diabetes?

1. Degludec insulin 10 units at bedtime

2. Regular insulin 10 units at bedtime

3. Glargine insulin 13 units at bedtime

4. Detemir insulin 25 units at bedtime

The correct answer is: Detemir insulin 25 units at bedtime

To determine the appropriate weight-based insulin dose recommendation, it is important to consider established guidelines and typical starting doses for insulin types. In general, weight-based dosing for insulin is often calculated based on the patient's weight in kilograms and their individual insulin sensitivity. For a type 2 diabetes patient, a common starting point is around 0.2 to 0.5 units of insulin per kilogram of body weight per day, with adjustments made based on blood glucose monitoring and individual response. The older male patient in question, at 63 years of age, likely requires extra consideration for his age, weight, and any potential insulin resistance. Detemir insulin (known for its longer action and stable profile) is often used in higher initial doses compared to others, such as degludec or glargine, which might be prescribed in lower doses. The selected dose of 25 units at bedtime would be consistent with an appropriate therapeutic regimen for managing diabetes, particularly if the man has a higher weight or is showing signs of insulin resistance. This dosage would help ensure adequate basal coverage overnight, support morning fasting blood glucose levels, and help with overall metabolic control. While the doses of the other insulins may be lower and still functional for some patients,