A breakfast tray was placed in front of a diabetic patient. The nurse checks the sugar and it displays 80 mg/dL. Lispro sliding scale <130–0 units, 131–150–1 unit, 151–200–2 units, 201–250–4 units, 251–300–6 units, 301–350–8 units, 351–400–10 units, >401–call MD. Which intervention should the nurse hold?

Choice A reason: Lantus (insulin glargine) is a long-acting basal insulin and may be part of the patient’s regular regimen. It is not held based on pre-meal glucose unless hypoglycemia is present or the patient is NPO. A glucose of 80 mg/dL is within normal fasting range. Choice B reason: Metformin is an oral hypoglycemic agent and is typically continued unless contraindicated by renal function or acute illness. It does not cause hypoglycemia on its own and is not held for a glucose of 80 mg/dL. Choice C reason: Glucagon is used to treat hypoglycemia, typically when blood glucose is below 70 mg/dL or if the patient is symptomatic and unable to eat. A glucose of 80 mg/dL does not warrant glucagon administration. This intervention should be held. Choice D reason: Giving the breakfast tray is appropriate. The patient’s glucose is within normal range, and food intake will help maintain glycemic stability.