If a patient with muscle cramping and a blood glucose level of 325 mg/dL presents for physical therapy, what is the most appropriate action?

• A. Postpone physical therapy, and contact the physician immediately.
• B. Postpone physical therapy, and advise the patient to contact the physician if symptoms worsen.
• C. Proceed with physical therapy at a decreased intensity, and contact the physician at the conclusion of the session.
• D. Proceed with the established physical therapy program, and contact the physician at the conclusion of the session.

Answer: (A)

When a patient with diabetes has a blood glucose level as high as 325 mg/dL along with symptoms like muscle cramping, it signals potential metabolic instability that requires medical evaluation before exertion. Exercise in this state can worsen dehydration and hyperglycemia and may mask or trigger diabetic ketoacidosis if not managed. For safety, the appropriate action is to postpone the session and contact the physician immediately for clearance and instructions before proceeding. Continuing with therapy or delaying only modestly could miss a critical medical evaluation, so seeking professional guidance now is the prudent course.