HomeAnswersEndocrinologyhypoglycemiaHow to manage hypoglycemic episodes in diabetic patients?

How can I manage hypoglycemic episodes in a diabetic patient under antidiabetic medication?

Share

The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.

Medically reviewed by

iCliniq medical review team

Published At September 2, 2022
Reviewed AtOctober 10, 2023

Patient's Query

Hello doctor,

I am a specialist doctor and wanted to consult you regarding advice for a patient.

A 50-year-old patient was recently discharged from the hospital with symptomatic (slurred speech and confusion) hypoglycemic episodes with glucose levels of 36 mg/dL. The patient is on a regimen of five oral anti glycemic medications (Metformin, Sitagliptin, Pioglitazone, Glimepiride, and Meglitinide full doses) and basal Insulin Glargine of 35 units. I ordered an A1C test for the patient, which showed a value of 6.4 %. I discontinued Glimepiride and Meglitinide and decreased the night-time basal Insulin to 25 units. However patient continues to have morning fasting hypoglycemic episodes ranging from 50 to 70 mg/dL and is asymptomatic. Lunch and breakfast glucose levels range between 170 to 300 mg/dL. The more I try to titrate the Glargine down, the higher the lunch and dinner glucose. Recently I decided to start SLGT-2 inhibitors for her as I continue to decrease the long-acting Glargine. Would you please suggest a treatment plan for the patient to prevent further hypoglycemic episodes?

Thank you.

Hello,

Welcome to icliniq.com.

I read your query and understand your concern.

The following are my suggestions:

1. Stop all oral diabetes tablets.

2. Stop basal Insulin at night.

3. Start plain Insulin four times a day according to the random blood sugar (RBS) value on the glucometer.

I hope I have solved your query.

Thank you.

Same symptoms don't mean you have the same problem. Consult a doctor now!

Dr. Kaushal Bhavsar
Dr. Kaushal Bhavsar

Pulmonology (Asthma Doctors)

Community Banner Mobile
By subscribing, I agree to iCliniq's Terms & Privacy Policy.

Ask your health query to a doctor online

Endocrinology

*guaranteed answer within 4 hours

Disclaimer: No content published on this website is intended to be a substitute for professional medical diagnosis, advice or treatment by a trained physician. Seek advice from your physician or other qualified healthcare providers with questions you may have regarding your symptoms and medical condition for a complete medical diagnosis. Do not delay or disregard seeking professional medical advice because of something you have read on this website. Read our Editorial Process to know how we create content for health articles and queries.

This website uses cookies to ensure you get the best experience on our website. iCliniq privacy policy