How should severe hypoglycemia with impaired consciousness be treated?

How should severe hypoglycemia with impaired consciousness be treated?

• A. Administer glucagon 1 mg IM (or IV/SC); if unconscious, call emergency services; after recovery, provide rapid carbs.
• B. Increase insulin dose
• C. Only offer oral sugar
• D. Hydration with IV fluids only

Answer: (A)

When blood sugar drops so low that consciousness is impaired, the priority is to raise the brain’s fuel quickly while the person can’t safely swallow. Glucagon given by intramuscular injection (1 mg) is the best option because it stimulates the liver to release stored glucose into the bloodstream, producing a rapid rise in blood glucose even when oral intake isn’t possible. If the person is unconscious, you should contact emergency services right away since they may need advanced monitoring and treatment. Once the person regains consciousness, provide rapid-acting carbohydrates to bring glucose up quickly and then a longer-acting source of carbohydrate to prevent another drop. Increasing insulin would make the situation worse; oral sugar isn’t safe when someone can’t swallow, and IV fluids alone without glucose won’t correct the hypoglycemia promptly.

When blood sugar drops so low that consciousness is impaired, the priority is to raise the brain’s fuel quickly while the person can’t safely swallow. Glucagon given by intramuscular injection (1 mg) is the best option because it stimulates the liver to release stored glucose into the bloodstream, producing a rapid rise in blood glucose even when oral intake isn’t possible. If the person is unconscious, you should contact emergency services right away since they may need advanced monitoring and treatment. Once the person regains consciousness, provide rapid-acting carbohydrates to bring glucose up quickly and then a longer-acting source of carbohydrate to prevent another drop.

Increasing insulin would make the situation worse; oral sugar isn’t safe when someone can’t swallow, and IV fluids alone without glucose won’t correct the hypoglycemia promptly.