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Hypoglycaemia fall — DGM MCQ

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ModerateFallsHypoglycaemia fallDGM

A 79-year-old man is found confused after collapsing before lunch. He has type 2 diabetes and poor appetite after bereavement. Capillary glucose is 2.4 mmol/L and symptoms improve with glucose. Current medicines include gliclazide, metformin and ramipril. What is the most likely diagnosis?

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Correct answer: E — Sulfonylurea-related hypoglycaemia

Documented low glucose with recovery after treatment indicates hypoglycaemia, and gliclazide is a common culprit in older adults with reduced intake. Vertigo disorders do not explain the glucose response, TIA would not correct with glucose, and normal pressure hydrocephalus is chronic. Falls in diabetes should prompt review of hypoglycaemia risk and glycaemic targets.

Reference: BNF; STOPP/START criteria v3