What is the recommended management for a conscious patient with hypoglycemia who cannot eat?

• A. 15-20 g carbohydrate or glucagon if unable to take oral intake; if severe, IV dextrose.
• B. Insulin injection
• C. Withhold all fluids
• D. Begin continuous ketone monitoring

Answer: (A)

Raising blood glucose quickly in hypoglycemia depends on whether the patient can take oral intake. If the person is conscious and able to swallow, the first move is a quick-acting carbohydrate about 15–20 g to raise the glucose promptly, with a recheck in about 15 minutes. If they cannot take oral intake, you switch to glucagon because this hormone prompts the liver to release glucose into the bloodstream, helping raise the level without eating. If the hypoglycemia is severe or glucagon is not effective or available, you escalate to IV dextrose to deliver glucose directly into the blood.

So in this scenario—conscious but unable to eat—the recommended steps are to give glucagon (if available) to stimulate glucose release, and if needed or if the situation is more severe, administer IV dextrose. This approach avoids insulin, which would worsen the low glucose, and it prioritizes rapid correction with the appropriate route based on the ability to take food.