What is the appropriate treatment for a patient with a BGL < 60 mg/dL who is alert?

• A. Administer insulin.
• B. Administer glucose paste or an oral glucose-containing agent if the patient can swallow.
• C. Do nothing.
• D. Give intravenous fluids only.

Answer: (B)

The main idea is treating hypoglycemia in a patient who is awake and able to swallow. When blood glucose falls below 60 mg/dL and the person can swallow, the fastest and safest fix is a rapid-acting oral glucose source, such as glucose paste or a glucose-containing drink. This quickly raises the blood sugar without needing IV access and leverages the patient’s ability to protect the airway and swallow safely.

Giving insulin would worsen the situation by driving glucose down further, so it’s not appropriate. Doing nothing leaves the hypoglycemia untreated and can lead to worsening symptoms or complications. Relying on IV fluids alone won’t correct low blood sugar unless those fluids contain glucose, and if the patient can swallow, the oral route is preferred for a quick correction.

After administering the oral glucose, check the blood glucose again in about 15 minutes and repeat the dose if still below target. Once stabilized, offer a longer-lasting carbohydrate to prevent recurrence. If the patient could not swallow or was unconscious, an alternative like IV dextrose or glucagon would be used instead of oral glucose.