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Chapter 43. Diabetes Mellitus

Student Questions

Which of the following statements regarding immunizations in patients with diabetes is true?

A. Hepatitis A vaccination is recommended for all patients with diabetes aged 60 years and older.

B. Influenza vaccinations are recommended for all patients with diabetes every 5 years.

C. Pneumococcal conjugate vaccination is recommended for all patients with diabetes aged 45 years and older.

D. Pneumococcal polysaccharide vaccination is recommended 1 year following pneumococcal conjugate vaccination.

Answer: D

Option A: Incorrect. Hepatitis B vaccination (not Hepatitis A vaccination) is recommended for all patients with diabetes aged 60 years and older.

Option B: Incorrect. Influenza vaccination is recommended annually, not every 5 years.

Option C: Incorrect. Pneumococcal conjugate vaccination is recommended for patients aged 65 years and older, not 45 years and older.

Option D: Correct. Pneumococcal polysaccharide vaccination is recommended in all patients with diabetes. Once they turn 65, it is recommended that they receive a dose of pneumococcal conjugate, and then they should receive a second dose of pneumococcal polysaccharide vaccination 1 year later.

A 12-year-old boy is newly diagnosed with type 1 diabetes. His current height is 60 in (152 cm) and he weighs 40 kg (88 lb). What dose of basal insulin should be initiated for him?

A. 12 units insulin glargine

B. 6 units insulin lispro

C. 4 units insulin detemir

D. 3 units insulin aspart

Answer: A

Option A: Correct. A recommended starting dose for insulin in a patient with T1DM is 0.6 to 1 units/kg/day. For this patient, that would be approximately 24 to 40 units per day total. Basal insulin should make up 50% of this dose, or 12 to 20 units, with the remainder being split between mealtime rapid acting insulin doses. Option A represents a correct starting basal insulin dose for this patient at 12 units of insulin glargine.

Option B: Incorrect. Six units is an incorrect dose for the initial basal component and insulin lispro is a rapid acting insulin.

Option C: Incorrect. Four units is an incorrect dose for the initial basal component though insulin detemir is a basal insulin option.

Option D: Incorrect. Three units is an incorrect dose for the initial basal component and insulin aspart is a rapid acting insulin.

Which of ...

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