What is the recommended treatment for a conscious patient with hypoglycemia?

• A. Administer 50% dextrose IV
• B. Wait and observe
• C. Administer 15–20 g of fast-acting carbohydrate, recheck in 15 minutes, repeat if still <70 mg/dL, then provide a complex carbohydrate snack
• D. Provide a protein shake only

Answer: (C)

The key idea is to raise blood glucose quickly in a conscious patient who can swallow, then keep it from dropping again. Start with 15–20 g of fast-acting carbohydrate (such as glucose tablets, fruit juice, or regular soda) and recheck the blood glucose in about 15 minutes. If it remains below 70 mg/dL, repeat the rapid-acting carb dose and recheck again. Once you’ve corrected the hypoglycemia, give a complex carbohydrate snack to help maintain normal levels and prevent another drop.

Iv dextrose is reserved for severe cases where the patient cannot swallow or is unconscious, so it isn’t the first choice here. Simply waiting could allow the hypoglycemia to worsen, and a protein shake alone won’t provide the rapid glucose surge needed.