What should be done for a patient with altered mental status and a history of diabetes?

• A. Administer glucose immediately
• B. Check BGL and treat per Glycemic Emergencies Protocol
• C. Place patient in Trendelenburg position
• D. Order MRI brain

Answer: (B)

When someone has altered mental status and a history of diabetes, the priority is to quickly assess for a glycemic emergency. Checking the blood glucose level and treating according to the Glycemic Emergencies Protocol is the best first step because it directly identifies whether hypoglycemia is the culprit and guides appropriate, life-saving treatment (like IV dextrose if glucose is low or glucagon if IV access isn’t available). Rushing to give glucose without confirming the glucose level risks inappropriate treatment if glucose isn’t actually low and could worsen other diabetes-related states. Trendelenburg positioning isn’t a recommended remedy for AMS and can cause harm, and an MRI won’t address the immediate stabilization needs. So, measuring BGL and treating per protocol provides the safest, evidence-based start to care.