What is a key instruction regarding NPH insulin administration?

NPH (Neutral Protamine Hagedorn) insulin is an intermediate-acting insulin that typically starts to work within 1 to 3 hours after administration, peaks around 4 to 12 hours, and lasts for up to 24 hours. The key instruction for administering NPH insulin is that it should be given about 30 minutes before a meal, particularly breakfast, to ensure that the onset of the insulin's action aligns with the rise in blood glucose levels that occurs after eating.

Administering NPH insulin at this time helps to effectively manage blood glucose levels throughout the postprandial period. The timing is particularly important because if given after meals, the insulin may not be effective in controlling the resulting spike in blood sugar. Ensuring this timing helps optimize glycemic control and minimizes the risk of hyperglycemia.

Other options also pertain to NPH insulin, but they either do not align with best practices or include additional considerations that could confuse proper administration. For example, while NPH can be administered at bedtime in certain cases to provide coverage during fasting periods, relying on bedtime administration can sometimes lead to unpredictable blood sugar patterns if the patient does not eat late in the evening. Shaking the vial before administration is also discouraged,