CLOSET HYPOGLYCEMIA

An elderly nondiabetic woman was found stuporous and unresponsive at h ome. In the emergency department, testing revealed that she had a seru m glucose of 40 mg/dL (2.2 mmol/L). No underlying metabolic cause coul d be determined. An inspection of her medications disclosed a professi onal medication sample bottle labeled as containing a nonsteroidal ant i-inflammatory drug (NSAID) that actually contained chlorpropamide tab lets. Drugs, notably sulfonylureas, must be considered as a possible c ause of unexplained severe hypoglycemia.