A 30-year-old male who manages his type 1 diabetes with glyburide presents at the emergency room reporting headache, confusion, and tachycardia. He has come from a party at which he drank two beers to celebrate running his first half-marathon. Which of the following is likely to be the cause of his complaints? A) Blood glucose levels are primarily a result of the timing, quantity, and character of food intake. B) Ingested glucose that is not needed for cellular metabolism circulates in the blood until it is taken up to meet cellular needs. C) Blood glucose levels are kept in a steady state by selective excretion and reuptake by the kidneys. D) Glucose that exceeds metabolic needs is converted and stored by the liver.

Glucose that exceeds metabolic needs is converted and stored by the liver

Explanation:

The patient is suffering from type 1 diabetes and takes glyburide which is an oral hypoglycemic.

In the glucose pathway, excess glucose will be converted to glycogen and will be stored in the liver. Under normal conditions, when the body needs excess glucose, like in the above case after a marathon run, glycogen converts back to glucose by the processes of glycogenolysis and gluconeogenesis.

Glyburide acts against increasing blood glucose levels by inhibiting glycogen conversion to glucose in the liver.

Hence, the blood lacks the necessary amount of glucose leading to hypoglycemic conditions. Further, an imbalance of glucose efflux and influx also lead to hypoglycemia.

Hyoglycemia can cause neurogenic and sympathoadrenal symptoms like headache, confusion, tachycardia. or postural orthostatic tachycardia syndrome.