Which insulin provides basal coverage?

Which insulin provides basal coverage?

• A. Insulin glargine
• B. Regular insulin
• C. NPH insulin
• D. Premixed NPH/Regular insulin

Answer: (A)

Basal insulin provides background, continuous coverage to suppress hepatic glucose production between meals and overnight. A long-acting insulin such as glargine is designed to deliver a steady, relatively peakless level for about 24 hours, making it well-suited for maintaining baseline glucose control with typically once-daily dosing. Regular insulin is fast-acting and is used to cover meals (bolus dosing), not to maintain background insulin levels. NPH is intermediate-acting and tends to have more variable absorption with a noticeable peak, which increases the risk of mismatches in coverage and nocturnal hypoglycemia. Premixed formulations combine short-acting and intermediate-acting components, providing both bolus and basal effects but with less flexibility and a prominent peak, so they aren’t ideal for true basal coverage. So, the long-acting basal insulin provides the continuous background control needed.

Basal insulin provides background, continuous coverage to suppress hepatic glucose production between meals and overnight. A long-acting insulin such as glargine is designed to deliver a steady, relatively peakless level for about 24 hours, making it well-suited for maintaining baseline glucose control with typically once-daily dosing.

Regular insulin is fast-acting and is used to cover meals (bolus dosing), not to maintain background insulin levels. NPH is intermediate-acting and tends to have more variable absorption with a noticeable peak, which increases the risk of mismatches in coverage and nocturnal hypoglycemia. Premixed formulations combine short-acting and intermediate-acting components, providing both bolus and basal effects but with less flexibility and a prominent peak, so they aren’t ideal for true basal coverage.

So, the long-acting basal insulin provides the continuous background control needed.