In unconscious hypoglycemia, what is the recommended treatment?

• A. Oral glucose tablet.
• B. IV dextrose 25-50 mL of 50% or IM glucagon 1 mg.
• C. 15 g of fast-acting carbohydrate.
• D. Withhold treatment until patient wakes.

Answer: (B)

When glucose is critically low and the person is unconscious, you must replace glucose quickly with a route that doesn’t require swallowing. Oral glucose forms can’t be used safely because the patient can’t protect the airway, so the standard approach is a parenteral glucose source or glucagon. Intravenous dextrose given as 25–50 mL of 50% solution delivers a large amount of glucose right away, raising blood sugar rapidly. If IV access isn’t available, intramuscular glucagon 1 mg is the alternative; it prompts the liver to release stored glucose and typically improves mental status within minutes. After administration, check blood glucose again and monitor the patient until stability is confirmed. Withholding treatment until the patient wakes or using oral carbs isn’t appropriate in this situation.