National Physical Therapy Examination (NPTE) Practice Exam

For a patient using an insulin pump with a blood glucose level of 95 mg/dL before exercise, what is the MOST appropriate response?

1. Reduce the insulin infusion dose

2. Increase the insulin infusion dose

3. Continue insulin infusion at the current metered dose

4. Rest for 1 hour, then remeasure blood glucose

The correct answer is: Reduce the insulin infusion dose

In the context of managing blood glucose levels for a patient using an insulin pump, a blood glucose level of 95 mg/dL is considered to be within the normal range. Before engaging in exercise, it’s important to ensure that blood glucose levels are stable and to anticipate the effects of physical activity on blood glucose metabolism. When a patient is planning to exercise and their blood glucose level is normal, reducing the insulin infusion dose is the most appropriate response. This adjustment is made because exercise can enhance insulin sensitivity, leading to a greater glucose uptake by muscles. If the recommended dose of insulin remains unchanged, there is a risk that blood glucose levels could decrease further during or after exercise, potentially leading to hypoglycemia. Other options, such as increasing the insulin infusion dose or continuing at the same dose, are not appropriate because they could worsen the situation by driving blood glucose levels lower during exercise. The option to rest for an hour and then remeasure blood glucose may delay the required response to ensure safety during exercise, as glucose levels can change quickly in a physically active state. Therefore, proactively managing insulin infusion by reducing the dose is the best course of action to maintain optimal blood glucose levels during exercise.