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Sulfonylurea hypoglycaemia — DGM MCQ

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ModeratePolypharmacySulfonylurea hypoglycaemiaDGM

An 80-year-old man has early morning confusion and a fall. His appetite is poor and HbA1c is 42 mmol/mol. Capillary glucose during an episode is 2.6 mmol/L. Current medicines include gliclazide, metformin and atorvastatin. Which medication should be reviewed?

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

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Correct answer: DGliclazide

Gliclazide can cause hypoglycaemia, particularly with poor intake and tight glycaemic control in older people. Metformin rarely causes hypoglycaemia alone, and atorvastatin, paracetamol and colecalciferol do not explain low glucose. Glycaemic targets should be individualised in frailty and multimorbidity.

Reference: NICE NG56; BNF