Prehospital identification of hypoglycemia-induced seizure using a smartphone-linked continuous glucose monitoring...

Seizures are a common reason for emergency medical service (EMS) activation. Among various etiologies, hypoglycemia is relatively rare in prehospital settings, and blood glucose measurements at symptom onset are often unavailable. Continuous glucose monitoring (CGM) devices synchronized with smartphone applications can provide real-time or retrospective glucose data, potentially supporting prehospital clinical assessment. This case report describes a 37-year-old man with type 1 diabetes mellitus who experienced a generalized tonic-clonic seizure while shopping with his seven-year-old son. Using a smartphone application linked to the patient's CGM device, the child identified a critically low glucose level at seizure onset. Based on this information, emergency medical services were promptly contacted. Upon EMS arrival, the seizure had resolved; however, the patient remained mildly agitated. Oral carbohydrate was administered, and subsequent point-of-care testing showed improvement in blood glucose levels. On arrival at the emergency department, no focal neurological deficits were observed. Clinical findings, together with CGM data, supported a diagnosis of hypoglycemia-induced seizure. This case highlights two important aspects of both prehospital care and emergency settings. First, smartphone applications linked to CGM devices can provide valuable information regarding glucose trends during transient neurological events. Second, such applications can be effectively used even by individuals without medical training, including children, to recognize abnormal glucose patterns and facilitate appropriate emergency response. Awareness of this novel use of CGM technology may help both prehospital and hospital-based providers better interpret prehospital information.