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Sulfonylurea hypoglycaemia — GPhC CRA MCQ

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EasyEndocrine TherapeuticsSulfonylurea hypoglycaemiaGPhC CRA

A 67-year-old man taking gliclazide 80mg twice daily feels sweaty and shaky while waiting in the pharmacy. His capillary blood glucose is 3.2mmol/L. He is alert, able to swallow and has not eaten since breakfast. What would you advise the patient?

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Correct answer: C — take 15g to 20g fast-acting carbohydrate and recheck glucose after 10 to 15 minutes

This is symptomatic hypoglycaemia in a person taking a sulfonylurea. The immediate management is fast-acting carbohydrate, followed by rechecking glucose and then a longer-acting carbohydrate if the next meal is not due. Giving more gliclazide would worsen hypoglycaemia. A high-fat snack delays glucose absorption and is not first-line rescue treatment.

Reference: BNF; NICE CKS: Diabetes type 2