Case Study #1 NT is a 17 year old Caucasian female who was a…
Case Study #1 NT is a 17 year old Caucasian female who was admitted recently to the hospital with a high plasma glucose concentration, ketonuria and the classic symptoms of type 1 diabetes mellitus. A confirmed diagnosis of type 1 DM was subsequently made. NT is now an outpatient in your clinic, and she is in the process of learning about the nutritional management of this disease, as well as how to administer insulin and monitor her glucose concentration. NT’s insulin regimen consists of insulin injections twice a day using a combination of short acting (regular) and intermediate (NPH) insulin before breakfast and before dinner. Seven months have elapsed since NT was diagnosed with diabetes mellitus. NT has been monitoring her blood glucose concentration and finds that her fasting morning blood sugar is consistently high. An evaluation of her usual eating habits and insulin regimen (as described in the case scenario) reveals that she is very compliant with what has been prescribed. You ask her to check her blood glucose in the middle of the night for several nights and the results show that she consistently has a low blood glucose concentration (hypoglycemia) at about 3 AM. From this information, you assess that NT’s elevated fasting morning blood glucose can probably be explained by: