In a conscious patient with hypoglycemia who cannot swallow, what is the recommended treatment?

In a conscious patient with hypoglycemia who cannot swallow, what is the recommended treatment?

• A. Intravenous saline
• B. Repeat oral glucose
• C. Insulin administration
• D. Glucagon injection.

Answer: (D)

When hypoglycemia leaves the patient unable to swallow, you need a treatment that raises blood glucose without oral intake. Glucagon injected into a muscle or under the skin does this by triggering the liver to break down stored glycogen and release glucose into the bloodstream. It acts quickly—often within minutes—making it the best rescue option in a conscious patient who cannot swallow. Intravenous saline doesn’t raise glucose at all; it only helps with fluid status. Repeating oral glucose isn’t possible if swallowing is compromised. Administering insulin would lower glucose further, which is clearly unsuitable. If glucagon isn’t available or glycogen stores are very depleted, intravenous dextrose can be used, but the scenario described points to glucagon as the appropriate first-line rescue treatment.

When hypoglycemia leaves the patient unable to swallow, you need a treatment that raises blood glucose without oral intake. Glucagon injected into a muscle or under the skin does this by triggering the liver to break down stored glycogen and release glucose into the bloodstream. It acts quickly—often within minutes—making it the best rescue option in a conscious patient who cannot swallow.

Intravenous saline doesn’t raise glucose at all; it only helps with fluid status. Repeating oral glucose isn’t possible if swallowing is compromised. Administering insulin would lower glucose further, which is clearly unsuitable. If glucagon isn’t available or glycogen stores are very depleted, intravenous dextrose can be used, but the scenario described points to glucagon as the appropriate first-line rescue treatment.