hypoglycemia

EM@3AM: Hypoglycemia

A 27-year-old female with a history of insulin-dependent diabetes presents to the ED on a Friday evening somnolent and disoriented. Her coworkers report she started slurring her speech and became increasingly altered after they met at a bar after work.  Exam reveals a diaphoretic, obtunded female not oriented to person, place, or time. Her GCS is 11. What do you suspect as the diagnosis? What should your first order be?

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