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A 66-year-old woman with COPD starts prednisone 40 mg each morning. Fasting glucoses are 116 to 130 mg/dL, but pre-dinner glucoses are 280 to 340 mg/dL. She is eating reliably. Which insulin strategy best targets this pattern?
Bedtime NPH insulin only
Morning NPH insulin titrated to afternoon and evening hyperglycemia
Sliding-scale insulin without basal coverage
Stop prednisone and use metformin alone
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