Choose Your Own Hypoglycemia Adventure: Mission Oaks

Bonnie Hill

Mr. Li is a 76 y/o man with a medical history of HTN, mild cognitive impairment, and type 2 diabetes managed with glypizide and insulin. The nurse giving you report notes that Mr. Li had "a good day" today and was less sedentary than he had been- even going for a walk with some encouragement. She takes you into the room to introduce you. Mr. Li is awake in a chair watching television. You notice several items of food are wrapped in napkins on his tray table. "The darn picture on this thing is all screwy" he barks at you, "Didn't I give you $50 last week to buy a new one?" The nurse seems alarmed and tells you that he is not normally this confused. While she checks his vitals, you check his blood sugar. It is 48 mg/dl. What do you do next?
A. Repeat the POC glucose with a fresh sample.
B. Give 4oz juice.
C. Give 1mg Glucagon subcutaneously.