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Sulfonylurea hypoglycaemia risk — GPhC CRA MCQ

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HardEndocrine TherapeuticsSulfonylurea hypoglycaemia riskGPhC CRA

A conscious older adult taking gliclazide is sweaty and confused after missing lunch. Capillary glucose is 3.1 mmol/L and they can swallow safely. What should be done first?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: B — Give fast carbohydrate, recheck in 10–15 minutes, then give slower carbohydrate

Option B gives the correct immediate sequence for a conscious person able to swallow: fast-acting carbohydrate, recheck after 10–15 minutes, repeat if still low, then longer-acting carbohydrate or a meal; recurrent sulfonylurea hypoglycaemia also needs review. Option A starts with carbohydrate that acts too slowly. Option C adds the causative medicine during treatment. Option E is not first choice while oral treatment is safe and omits follow-on carbohydrate. Option D may correct glucose too slowly and omits confirmation that the hypo has resolved.

Reference: NHS hypoglycaemia guidance: https://www.nhs.uk/conditions/low-blood-sugar-hypoglycaemia/