What is the recommended initial management for a patient with mild hypoglycemia (blood glucose <60 mg/dL)?

What is the recommended initial management for a patient with mild hypoglycemia (blood glucose <60 mg/dL)?

• A. Oral glucose 10-15 g, fast-acting carbohydrate, recheck in 15 minutes.
• B. IV bolus of normal saline.
• C. IM glucagon.
• D. Oral antacids.

Answer: (A)

When someone with mild hypoglycemia is awake and able to swallow, the priority is to raise blood glucose quickly with a fast-acting carbohydrate taken by mouth. Providing oral glucose in the range of about 10–15 g (a fast-acting carbohydrate) and then rechecking the blood glucose in 15 minutes is the best initial step. This approach delivers a rapid glucose surge to restore normal levels and assess the response promptly; if the level remains low or symptoms persist, you repeat the dose or move to a longer-acting carbohydrate to prevent recurrence. IV fluids don’t address the low glucose themselves, so an IV bolus of normal saline isn’t appropriate for correcting hypoglycemia. IM glucagon is reserved for patients who cannot take oral carbohydrates or who are unconscious. Oral antacids don’t affect blood glucose and won’t treat the hypoglycemia.

When someone with mild hypoglycemia is awake and able to swallow, the priority is to raise blood glucose quickly with a fast-acting carbohydrate taken by mouth. Providing oral glucose in the range of about 10–15 g (a fast-acting carbohydrate) and then rechecking the blood glucose in 15 minutes is the best initial step. This approach delivers a rapid glucose surge to restore normal levels and assess the response promptly; if the level remains low or symptoms persist, you repeat the dose or move to a longer-acting carbohydrate to prevent recurrence.

IV fluids don’t address the low glucose themselves, so an IV bolus of normal saline isn’t appropriate for correcting hypoglycemia. IM glucagon is reserved for patients who cannot take oral carbohydrates or who are unconscious. Oral antacids don’t affect blood glucose and won’t treat the hypoglycemia.