In which clinical situation would glucagon be used to raise blood glucose?

• A. During DKA treatment, to accelerate recovery.
• B. Severe hypoglycemia when IV glucose is not available.
• C. Hyperglycemia with dehydration.
• D. As routine outpatient therapy to manage fasting glucose.

Answer: (B)

Glucagon raises blood glucose by signaling the liver to rapidly convert stored glycogen into glucose and release it into the bloodstream, with additional support from gluconeogenesis. This makes it ideal as a rescue therapy during severe hypoglycemia when IV glucose isn’t available or when the patient cannot safely take fluids by mouth. An intramuscular or subcutaneous dose can quickly elevate glucose levels, buying time to establish IV access or administer other glucose sources. It isn’t used for high blood glucose or for routine outpatient glucose management, since those situations require insulin, fluids, and long-term metabolic control. The response depends on having hepatic glycogen stores, so in individuals with depleted stores from malnutrition, chronic alcohol use, or liver disease, the effect may be limited and IV glucose becomes necessary.