Glucose EAQs Practice Test

A morning dose of NPH given at 7 AM is most likely to cause hypoglycemia in which part of the day?

In the morning In the afternoon At night Immediately after injection

Correct Answer:

Immediately after injection

Explanation:

NPH insulin is an intermediate-acting insulin with a delayed onset and a peak several hours after injection. It typically begins to act about 1–2 hours after a dose, reaches its strongest effect around 6–14 hours later, and can last well into the evening. When a morning dose is given at 7 AM, its peak action—and thus the highest risk of hypoglycemia—occurs in the afternoon (roughly early to late afternoon, potentially extending into the evening). Hypoglycemia immediately after injection isn’t characteristic of NPH; rapid-acting insulins are more likely to cause that timing because they act quickly after administration. So the most likely time for hypoglycemia with a morning NPH dose is the afternoon.

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