A 56-year-old female with type II diabetes mellitus is admit…

A 56-year-old female with type II diabetes mellitus is admitted for elective knee replacement surgery. She is NPO after midnight in preparation for surgery. Her home diabetes regimen includes: Insulin glargine (Lantus) 30 units at bedtime Insulin lispro (Humalog) 8 units with meals Metformin 1000 mg BID On morning labs, her fasting blood glucose is 142 mg/dL. A1c 1 month ago is 8.5 mmol/L. The surgical team asks the AGACNP to manage her diabetes medications. Which is the most appropriate insulin adjustment for this patient on the morning of surgery?