Once enteral nutrition administration is stable what type of insulin regimen should be used?

• A. Sliding-scale insulin only
• B. Basal insulin only
• C. Basal/bolus insulin regimen
• D. Premixed NPH/Regular insulin

Answer: (C)

The key idea is matching insulin delivery to the predictable carbohydrate input from enteral nutrition. When EN is stable, you want a regimen that provides lasting background insulin plus insulin given at meals or with feeds to cover the glucose surge from carbohydrates. A basal/bolus approach does just that: a long-acting basal insulin maintains steady insulin during fasting periods, while rapid-acting bolus insulin is used at feeding times to cover the post-feed glucose rise. This provides tighter, more predictable glucose control and reduces fluctuations compared with reactive sliding-scale insulin that only treats highs after they occur. A basal-only plan misses postprandial spikes, and premixed insulin lacks the flexibility to adjust the balance between basal and bolus dosing for changing feeding patterns.