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Sulfonylurea hypoglycaemia — GPhC CRA MCQ

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HardEndocrine TherapeuticsSulfonylurea hypoglycaemiaGPhC CRA

A frail 79-year-old taking gliclazide has recurrent capillary glucose readings of 2.6–3.0 mmol/L after reduced food intake. Symptoms initially improve with oral glucose but recur several hours later. What is the priority?

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Correct answer: A — Treat the episode, continue glucose monitoring and obtain same-day clinical assessment

Gliclazide stimulates insulin release and hypoglycaemia may be severe, prolonged or recurrent, especially in older, undernourished patients or when meals are inadequate. Repeated low readings after initial glucose treatment require urgent assessment, continued monitoring and review of gliclazide dose, renal function, intake and glycaemic goals. Simply changing dose timing or waiting for routine HbA1c is unsafe.

Reference: Gliclazide Summary of Product Characteristics: https://www.medicines.org.uk/emc/product/13135/smpc