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Sulfonylurea hypoglycaemia risk — GPhC CRA MCQ

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ModerateEndocrine TherapeuticsSulfonylurea hypoglycaemia riskGPhC CRA

A 79-year-old woman with type 2 diabetes is prescribed gliclazide 80mg twice daily. She has started eating poorly after bereavement and has had two falls with sweating before lunch. Her eGFR is 42mL/min/1.73m2 and HbA1c is 48mmol/mol. What is the most appropriate alternative?

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Correct answer: E — Ask the prescriber to review gliclazide dose and hypoglycaemia risk

Sulfonylureas can cause hypoglycaemia, particularly in older adults with reduced intake or renal impairment. Sweating before lunch and falls are compatible with hypoglycaemic episodes. The prescriber should review treatment intensity and safety. A satisfactory HbA1c does not exclude harmful hypoglycaemia.

Reference: BNF Gliclazide; NICE CKS Diabetes type 2