If a CGM shows a rapid decline into hypoglycemia and the patient is symptomatic, what is the recommended action?

If a CGM shows a rapid decline into hypoglycemia and the patient is symptomatic, what is the recommended action?

• A. Ignore the CGM and proceed
• B. Immediately double insulin dose
• C. Confirm with SMBG and treat with fast-acting carbohydrate; check for device issues
• D. Call emergency services

Answer: (C)

The key idea is that CGM readings can lag behind actual blood glucose during rapid changes, so you verify before acting. If someone has symptoms of hypoglycemia, first confirm the reading with a fingerstick SMBG. If it’s low, treat immediately with fast-acting carbohydrates to raise blood sugar quickly, then recheck in about 15 minutes and repeat if still low. Also take a moment to check the CGM device for issues—sensor placement, calibration needs, or other malfunctions that could explain a sharp drop. Avoid increasing insulin dose in response to a suspected CGM drop, and seek emergency help if the person cannot swallow or loses consciousness.

The key idea is that CGM readings can lag behind actual blood glucose during rapid changes, so you verify before acting. If someone has symptoms of hypoglycemia, first confirm the reading with a fingerstick SMBG. If it’s low, treat immediately with fast-acting carbohydrates to raise blood sugar quickly, then recheck in about 15 minutes and repeat if still low. Also take a moment to check the CGM device for issues—sensor placement, calibration needs, or other malfunctions that could explain a sharp drop. Avoid increasing insulin dose in response to a suspected CGM drop, and seek emergency help if the person cannot swallow or loses consciousness.