Define hypoglycemia and describe treatment for conscious and unconscious patients.

• A. Blood glucose <60 mg/dL; treat with exercise.
• B. Blood glucose <70 mg/dL; conscious: 15 g fast-acting carbohydrate; recheck after 15 minutes; unconscious or unable to swallow: IV dextrose 25-50 mL of 50% or IM glucagon 1 mg.
• C. Blood glucose <50 mg/dL; conscious: water; unconscious: no treatment.
• D. Blood glucose <90 mg/dL; treat with insulin.

Answer: (B)

Hypoglycemia means the blood glucose level is too low, and the proper treatment depends on whether the person can safely swallow and protect their airway. The standard guideline uses a threshold of about 70 mg/dL. For a conscious person who can swallow, give roughly 15 grams of fast-acting carbohydrate (such as glucose tablets, juice, or regular soda), then recheck the blood glucose in about 15 minutes. If it’s still low, repeat the 15-gram dose. Once the level is above 70 mg/dL, have a small snack or meal to maintain it and prevent another drop. For someone who is unconscious or unable to swallow, do not give anything by mouth. If IV access is available, administer 25–50 mL of 50% dextrose; if not, give an intramuscular glucagon 1 mg. After recovery, continue to monitor and address the cause of the hypoglycemia.

Other options don’t fit because they either use an incorrect threshold or prescribe inappropriate treatment: exercise or insulin would worsen low blood glucose, and giving only water or no treatment is not sufficient for a hypoglycemic state.