Clinical Chemistry - Case Study

The High Cost of Low Quality: Recurring Hypoglycemia in a 63-Year-Old Man


A 63-year-old man was discovered unresponsive at home. He was found to be diaphoretic and severely hypoglycemic, with a plasma glucose of 26 mg/dL (1.44 mmol/L). His blood pressure was 196/96 mmHg and pulse 59 beats per minute. He demonstrated shallow respirations at 10 breaths per minute. 2.5 mg naloxone and 50 mL of 10% dextrose were administered. Plasma glucose increased to 170 mg/dL (9.44 mmol/L) in transit to the hospital, and he continued to display altered mental status. On arrival, his plasma glucose had decreased to 88 mg/dL (4.89 mmol/L) and 45 minutes later was 28 mg/dL (1.55 mmol/L). 50 mL of 50% dextrose were administered and glucose was measured every 30 minutes. Healthcare providers learned he had taken an unknown amount of a purportedly natural male-enhancement supplement called “V8” that morning.