When hypoglycemia is suspected in a conscious patient, what is the recommended initial management?

• A. Provide a fast-acting carbohydrate and recheck glucose.
• B. Administer intravenous fluids only.
• C. Administer a long-acting insulin dose.
• D. Wait and observe for 15 minutes.

Answer: (A)

When hypoglycemia is suspected in a conscious patient, the priority is to raise blood glucose quickly with a fast-acting carbohydrate that can be swallowed. Give about 15-20 grams of glucose-equivalent carbohydrate (for example, glucose tablets, fruit juice, regular soda, or candy) and then recheck blood glucose in about 15 minutes. If the level has risen and symptoms resolve, offer a small snack to maintain glucose until the next meal. If glucose remains low or symptoms persist, repeat the fast-acting carbohydrate and recheck. Avoid waiting or giving long-acting insulin in this moment. If the patient cannot swallow or remains unconscious, escalate to IV dextrose or glucagon per protocol.