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Nocturnal hypoglycaemia on insulin — GPhC CRA MCQ

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HardEndocrine TherapeuticsNocturnal hypoglycaemia on insulinGPhC CRA

A 71-year-old woman receiving insulin glargine at night reports sweating and confusion at 3am twice this week. Her fasting glucose has been 4.1 to 4.5mmol/L and she recently reduced evening meals due to nausea. She lives alone. What is the most appropriate action?

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

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Correct answer: E — Refer to the diabetes team or prescriber for urgent insulin review

Recurrent nocturnal hypoglycaemia in a patient using basal insulin is a safety concern, especially when living alone. Reduced evening intake and low fasting readings indicate the insulin regimen may need adjustment. The pharmacist should advise hypoglycaemia treatment and arrange urgent clinical review.

Reference: BNF; NICE CKS