مريض سكري نوع ٢ يأخذ إنسولين NPH ٤٠ وحدة كل صباح، صائم لعملية الساعة ١٠. سكره الساعة ٦ صباحاً ١٤٢. ما الأنسب؟

A client with type 2 diabetes takes NPH insulin 40 units every morning and is NPO for 10:00 surgery. His 06:00 glucose is 142 mg/dL. What is most appropriate?

1. The full usual NPH dose on the morning of surgery
2. A glass of juice an hour before surgery
3. The reduced pre-op dose as ordered, with glucose checks
4. Hold all insulin without checking any order

Answer: C) The reduced pre-op dose as ordered, with glucose checks. A fasting client risks hypoglycaemia, while stopping insulin entirely can cause marked hyperglycaemia. The usual protocol is about half the NPH dose on the morning of surgery with frequent glucose checks.