Choose Your Own Hypoglycemia Adventure: Medical Patient

Bonnie Hill

Mr. Johnson is a patient with type 1 diabetes and chronic kidney disease who was admitted last week with pneumonia and high blood sugars. You get in bedside report that his sugars had all been 150 mg/dl and above until yesterday when they ranged from 80mg/dl to 100 mg/dl. The previous shift nurse tells you that his condition is improving, he is tolerating his low sodium, carb-controlled, fluid-restricted diet well, and the last CBG she checked was 82 mg/dl. The patient interrupts report stating "Will you two hens stop talking about me like I'm not here?" The nurse seems surprised by his outburst and tells you this is uncharacteristic for him. While she checks his vitals, you check his blood sugar. It is 55 mg/dl. What do you do?
A. Give 4oz apple juice
B. Give 15g liquid glucose gel
C. Repeat the POC glucose test with a new sample