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Question 141 · LEK · Emergencies and acute complications

Indicate the proper management of the patient with type 2 diabetes mellitus treated with gliclazide retard, who presents with sweat, fatigue and trembling hands and his blood glucose concentration as measured by glucose meter is 61 mg/dL:

  1. A. immediately give 1 mg of glucagon i.m. or s.c. and then 500 mL of 10% glucose solution in intravenous infusion and perform a control measurement of glycemia after 30 minutes.
  2. B. give slow intravenous infusion of 20% glucose solution in 250 mL of normal saline and perform control measurements of glycemia every 30 minutes.
  3. C. give simple carbohydrates, e.g. sweetened tea and then complex carbohydrates, e.g. a sandwich of full-grain bread and perform a control measurement of glycemia after an hour.
  4. D. first give the patient 50 mL of 20% glucose solution i.v. and then 500 mL of 10% glucose solution with a control measurement of glycemia after 15 minutes.
  5. E. in the case of hypoglycemia related to the use of sulfonylureas it is indicated to use the rule of 15/15.
Hint

The patient is conscious and can eat, so think of oral treatment first and remember the long action of the sulfonylurea.

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