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Interactive diabetes case 7: Management of diabetes in a 72-year-old patient with type 2 diabetes, GI bleeding, and multiple other medical problems – A2

Interactive diabetes case 7: Management of diabetes in a 72-year-old patient with type 2 diabetes, GI bleeding, and multiple other medical problems – A2
Author:
Lloyd Axelrod, MD
Literature review current through: Apr 2025. | This topic last updated: Apr 21, 2025.

ANSWER — 

Incorrect.

The patient is brought to the emergency department by his family one week later because of headaches and intermittent confusion. The blood glucose level on arrival is 33 mg/dL (1.8 mmol/L). The patient is given 25 mL of 50 percent dextrose intravenously and improves rapidly. An intravenous glucose infusion is started. The patient is admitted to the hospital for intravenous glucose therapy and monitoring until hyperglycemia returns and his insulin can be resumed safely. He is discharged three days later on insulin with a diagnosis of glyburide-induced hypoglycemia in a patient with chronic kidney disease.

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