How to Approach a Patient With Hypoglycemia

The patient is a 19 year old man with a history of sensory neural hearing loss who presented to the ED with altered mental status. He was in his usual safe health up until about two to three days prior when he developed subjective fevers and upper respiratory symptoms. The day before presentation, he visited a physician who gave him pseudofed and Tamiflu. On arrival to the ED, he was noted to be very confused but awake. An initial blood pressure was 100 over 60 and a fingers to glucose was 24. Shortly after receiving the D50, his mental status improved. And neurologically, at this point, he was awake, alert and appropriate.