The insulin regimen of a Type 2 diabetic presenting for surgery had been changed recently from a 70/30 mixture of insulin aspart protamine and aspart to insulin detemir and insulin glulisine. Preoperative instructions were to take the usual dose of basal, but none of the short-acting insulin. On the morning of surgery, the patient's blood glucose was low and remained so despite i.v. dextrose administration. A review of the basal insulin dose revealed that it had been inappropriately increased...