Glucose gel indication?

• A. Unconscious patient with a history of diabetes controlled by medication.
• B. Altered mental status with history of diabetes controlled by medication, conscious and capable of swallowing.
• C. Suspected poisoning.
• D. Pediatric patient with dehydration.

Answer: (B)

The main idea being tested is when oral glucose gel is appropriate to treat hypoglycemia. Glucose gel is used for a conscious patient who can swallow to rapidly raise blood sugar without needing IV access. In this scenario, the patient has a history of diabetes and is altered mentally but still awake and able to swallow, making glucose gel an appropriate, quick-acting treatment. The gel should be placed in the cheek to dissolve and absorb quickly; after administration, reassess mental status and, if available, check blood glucose.

Glucose gel isn’t used if the patient is unconscious or unable to protect the airway, because there’s a risk of choking or aspiration. It also isn’t indicated for suspected poisoning or for dehydration in a child. If the patient doesn’t improve promptly, escalate with IV dextrose or glucagon per protocol and monitor closely.