Endocrine Case Report: Glucose of 30 mg/dL

The latest endocrine case report from Brady Pregerson, MD, features a man in his mid-70’s with a recent UTI brought to the hospital with a glucose of 30 mg/dL and reports of generalized weakness. Can you determine the correct diagnosis?

History of Present Illness:

A man in his mid-70’s with a recent UTI is brought to the hospital by ambulance with a glucose of 30 after family called 911 for generalized weakness. Medics gave an amp of D50 and he gradually became less weak. He is 4 days into the second course of antibiotics for a UTI but denies any fever, pain, or other complaints. He has a history of Parkinson’s and HTN, but no diabetes or other endocrine conditions.

Vital Signs & Physical Exam:

Vital signs are normal. Physical exam is non-focal

Initial Diagnostic Testing:

CBC: normal except for chronic anemia

Chem-7: normal except for Cr = 1.6

Imaging: none

What is the most likely cause of the low glucose?