Case presentation A 77-year-old woman had been experiencing light-headedness for several weeks. She had a history of type 1 diabetes and presented to the clinic when she experienced syncope and fell on the ground. She had not experienced any episodes of hypoglycemia. Examination Her electrocardiogram revealed tachycardia, though head CT did not reveal hemorrhage. Laboratory investigations revealed a blood glucose level of 34 mg/dL.
The patient was immediately given an intravenous dose of 25 grams of dextrose. Over the next 12 hours, glucose levels were constantly monitored, which remained between 179-303 mg/dL. Medication She was initially treated with insulin lispro 4 units TID with meals and insulin glargine 24 units. Other medications included ezetimibe, fluoxetine, enoxaparin prophylaxis, lisinopril, levothyroxine, pravastatin, and potassium chloride. She was later given an…
