Which statement about insulin management is NOT appropriate?

• A. Rotate the insulin injection sites systematically.
• B. Keep insulin vials refrigerated at all times.
• C. Monitor urine acetone level to determine the insulin dosage.
• D. Increase the amount of insulin before unusual exercise.

Answer: (D)

When planning insulin around exercise, the goal is to prevent hypoglycemia. Exercise increases muscle glucose uptake and insulin sensitivity, so boosting the insulin dose before unusual exercise would lower blood glucose too much and is not appropriate. The other practices align with standard care: rotating injection sites helps prevent lipodystrophy and keeps absorption consistent; unopened insulin vials should be kept in the refrigerator to preserve potency; and while ketone testing (urine acetone) is important for detecting ketosis or diabetic ketoacidosis, it does not determine insulin dosage.