What is the recommended treatment for hypoglycemia presenting as coma?

What is the recommended treatment for hypoglycemia presenting as coma?

• A. Oral glucose
• B. IV glucose
• C. IM glucagon
• D. IV saline

Answer: (B)

In hypoglycemic coma, the priority is to rapidly raise the blood glucose because the patient cannot swallow or protect the airway. Administer intravenous glucose right away, typically a bolus of 25 g of dextrose (50 mL of 50% D50) given IV push, with an ongoing IV dextrose infusion if needed to maintain euglycemia. Recheck blood glucose after the bolus and monitor closely until stable. Oral glucose isn’t feasible in a comatose patient due to the risk of aspiration. Intramuscular glucagon can be used if IV access isn’t available, but its onset is slower and it depends on hepatic glycogen stores, making it unreliable in chronic alcohol use or malnutrition. IV saline won’t correct the low glucose level. After stabilization, treat the underlying cause of the hypoglycemia.

In hypoglycemic coma, the priority is to rapidly raise the blood glucose because the patient cannot swallow or protect the airway. Administer intravenous glucose right away, typically a bolus of 25 g of dextrose (50 mL of 50% D50) given IV push, with an ongoing IV dextrose infusion if needed to maintain euglycemia. Recheck blood glucose after the bolus and monitor closely until stable.

Oral glucose isn’t feasible in a comatose patient due to the risk of aspiration. Intramuscular glucagon can be used if IV access isn’t available, but its onset is slower and it depends on hepatic glycogen stores, making it unreliable in chronic alcohol use or malnutrition. IV saline won’t correct the low glucose level. After stabilization, treat the underlying cause of the hypoglycemia.