Endocrine Case Report: Hypoglycemia and Abnormal EKG

Our latest endocrine case report from Brady Pregerson, MD, features an elderly woman with a history of diabetes experiencing sweats, light-headedness, nausea, and SOB. Can you determine the correct diagnosis?

History: An elderly lady with a history of diabetes mellitus who just switched from metformin to insulin is BIBA for sweats, light-headedness, nausea, and SOB, all lasting about 1 hour. Her glucose was measured at 68 by medics and symptoms resolved after juice and food that she was consuming as medics arrived. She denies any chest pain, abdominal pain, vomiting, or other complaints.

Exam: Vital signs are normal as is her physical exam other than visible diaphoresis

An EKG is done

What is the most likely diagnosis?