]> 2026-07-31T07:51:23+00:00 WBR0920 0 en Increasing the evening dose of insulin '''Incorrect'''-Increasing the evening dose of insulin will only worsen this condition. Switching from NPH to lispro Increasing the morning dose of insulin '''Incorrect'''-Increasing the morning dose of insulin will be necessary only if there was an increase in early morning blood glucose without a hypoglycemic episode at night, which is Dawn phenomenon. Switching from NPH to regular insulin Decreasing the evening dose of insulin '''Correct'''-After documentation of hypoglycemia during night and confirmation of Somogyi phenomenon, reducing the evening or night insulin dose (short acting or intermediate acting) is the first appropriate step in management. Community Medical Health Center Primary Care Office Inpatient Facilities Vendhan Ramanujam A 18 year old boy is brought to the physicians office by his mother, with complains of sweats and headaches during the nights. Initially he was started on NPH insulin, 30 U each morning and 15 U every night. But following a persistent morning glycosuria that did not improve, the evening dose was increased to 20 U during his last visit. His recent lab tests reveal worsening of his morning glycosuria with moderate ketones in his urine. Several consecutive nights glucose monitoring was done and it revealed hypoglycemia. Somogyi phenomenon is diagnosed. What will be the next best step in management of this patient E Endocrine 2020-10-28T02:04:52Z 2459150.586713 WBR0920