What is the recommended action if a patient refuses further treatment after hypoglycemic episodes?

• A. Administer oral glucose without consent
• B. Force treatment if impaired
• C. Ensure they have sources of glucose at home and family members or bystanders to observe them
• D. Transport them to hospital

Answer: (C)

When a patient with a history of hypoglycemia chooses to refuse further treatment, the priority is to support safe self-management while respecting their decision. If they are competent to decide, acknowledge their autonomy and focus on practical safety measures. The best action is to ensure they have readily available sources of glucose at home (like glucose tablets or juice) and arrange for a family member or bystander to be present or observe them. This creates a safety net: the patient can promptly treat any future low blood sugar, and a helper can assist if symptoms recur or if the patient needs support, without overriding their choice. It also provides an opportunity to reinforce education about recognizing hypoglycemia, knowing when to seek help, and preventing future episodes. Administering glucose without consent would violate autonomy, and forcing treatment is not appropriate if the patient is capable of refusing. Transport to hospital is not required solely due to refusal unless the patient loses capacity or their condition worsens and they cannot protect themselves.