Hypoglycaemia sulfonylurea — GPhC CRA MCQ

Correct answer: B — Take 15–20 g rapid carbohydrate, recheck in 10–15 minutes, repeat if low, then take follow-on carbohydrate

Take 15–20 g rapid carbohydrate, recheck in 10–15 minutes, repeat if low, then take follow-on carbohydrate: A conscious patient with probable sulfonylurea-associated hypoglycaemia needs rapid glucose, early reassessment, repetition until recovered and follow-on carbohydrate, followed by medication review. Take 5–10 g rapid carbohydrate, recheck in 10–15 minutes, stop if improved, then omit follow-on food: The 10–15-minute recheck is appropriate, but 5–10 g is below the recommended initial amount and omitting follow-on carbohydrate increases recurrence risk. Take 20 g chocolate, recheck in 10–15 minutes, repeat chocolate if low, then resume the usual meal plan: Chocolate contains substantial fat that delays glucose absorption, so it is not the preferred rapid treatment even though the recheck timing is appropriate. Eat the missed meal, recheck in 45–60 minutes, use 15–20 g rapid carbohydrate only if symptoms persist, then resume gliclazide: A meal may not correct glucose rapidly enough and delaying rapid carbohydrate and reassessment for 45–60 minutes is unsafe. Take 15–20 g rapid carbohydrate, recheck in 10–15 minutes, take the next gliclazide dose, then eat the missed meal: The initial treatment and recheck are appropriate, but taking another sulfonylurea dose before medication review risks recurrent hypoglycaemia.

Reference: BNF: gliclazide: https://bnf.nice.org.uk/drugs/gliclazide/