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Sulfonylurea hypoglycaemia — SCE Endocrinology MCQ

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EasyDiabetesSulfonylurea hypoglycaemiaSCE Endocrinology

A 68-year-old man with type 2 diabetes develops tremor, sweating and confusion at 04:00. Capillary glucose is 2.1 mmol/L. He takes gliclazide modified release, metformin and ramipril; eGFR is 34 ml/min/1.73 m2. What is the most likely cause?

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Correct answer: B — Prolonged sulfonylurea-associated hypoglycaemia

Gliclazide can cause prolonged hypoglycaemia, particularly in renal impairment and older adults. Metformin by itself rarely causes hypoglycaemia. The key management implication is observation and treatment may need to be prolonged after sulfonylurea exposure.

Reference: BNF; JBDS Hypoglycaemia Guideline