A 68-year-old man with type 2 diabetes and eGFR 36 ml/min/1.73 m² has recurrent nocturnal hypoglycaemia. HbA1c is 49 mmol/mol and he lives alone

Question

A 68-year-old man with type 2 diabetes and eGFR 36 ml/min/1.73 m² has recurrent nocturnal hypoglycaemia. HbA1c is 49 mmol/mol and he lives alone after a recent fall. He takes gliclazide 160 mg twice daily and metformin 500 mg twice daily. What is the most appropriate management?

Accepted Answer

De-intensify sulfonylurea therapy and individualise the HbA1c target

Answer

Set a universal HbA1c target of 42 mmol/mol

Answer

Stop glucose monitoring

Answer

Increase gliclazide to improve HbA1c

Answer

Add bedtime rapid-acting insulin

Hypoglycaemia from diabetes overtreatment — SCE Endocrinology MCQ

A 68-year-old man with type 2 diabetes and eGFR 36 ml/min/1.73 m² has recurrent nocturnal hypoglycaemia. HbA1c is 49 mmol/mol and he lives alone after a recent fall. He takes gliclazide 160 mg twice daily and metformin 500 mg twice daily. What is the most appropriate management?