What is the most appropriate additional insulin therapy for a patient needing control of postprandial glucose?

Insulin lispro is a rapid-acting insulin that is specifically designed to provide control of postprandial glucose levels, which are the blood glucose levels that rise after meals. Due to its quick onset and short duration of action, insulin lispro effectively lowers blood glucose levels when taken just before or immediately after eating. This makes it particularly suitable for managing sharp increases in blood sugar that occur following meals.

In contrast to longer-acting insulin options, such as insulin degludec or NPH insulin, which are more beneficial for maintaining basal insulin levels and overall glucose control throughout the day, insulin lispro is engineered to meet the immediate insulin needs associated with food intake. Additionally, the combination of NPH/regular 70/30 insulin includes a mixture of intermediate-acting and short-acting insulin, which can provide both basal and prandial coverage but may not be as effective or as precise as using a rapid-acting insulin like insulin lispro for addressing postprandial spikes.

Thus, for a patient specifically needing control of postprandial glucose, insulin lispro is the most appropriate choice due to its pharmacokinetic profile that aligns with the rapid increase in blood glucose levels following meals.