BMJ Case Reports 2014; doi:10.1136/bcr-2014-204067

Hypoglycaemia in a 94-year-old man without diabetes

  1. Jay H Shubrook2
  1. 1Edward Via Virginia College of Osteopathic Medicine, Spartanburg, South Carolina, USA
  2. 2Ohio University Heritage College of Osteopathic Medicine, Athens, Ohio, USA
  1. Correspondence to Dustin James Mullens, dmullens{at}
  • Accepted 22 April 2014
  • Published 20 May 2014


Recognising a hypoglycaemic event in a person without a history of diabetes poses quite a challenge. A 94-year-old man without diabetes in an extended care facility (ECF) was found unconscious and non-responsive with a glucose level of 30 mg/dL. The patient required multiple resuscitations with glucagon and intravenous glucose before his blood glucose stabilised. Ultimately the accidental administration of a sulfonylurea was found to be responsible for the event. The patient fortunately recovered after 5 days of hospitalisation. Adults aged 65 years and older carry a significantly higher risk of serious adverse drug events (ADEs) requiring hospitalisation. Antidiabetic drugs cause nearly one-quarter of all hospitalisations from ADEs, with more than 99% due to unintentional overdose. To truly optimise patient care, providers must be cognizant of the risks associated with diabetes management to better monitor and prevent future occurrence of such taxing events.

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