In hypoglycemia, when is oral glucose indicated?

• A. In an unconscious patient
• B. In any patient with suspected hypoglycemia regardless of swallowing
• C. Only if patient is diabetic
• D. In an awake patient who can swallow and has signs of low blood glucose

Answer: (D)

Oral glucose is appropriate when the patient is awake and able to swallow. In this situation, a fast-acting glucose source can be absorbed safely from the mouth and stomach, raising blood sugar quickly and improving symptoms. The key safety point is airway protection: if the patient is unconscious or cannot swallow, giving oral glucose risks choking or aspiration, so nonoral routes (such as IV dextrose or glucagon) are used instead. The patient’s diabetic status does not determine eligibility—any person with hypoglycemia who can swallow and protect their airway is a candidate for oral glucose. After giving it, recheck blood glucose in about 15 minutes to ensure improvement and decide on further treatment. If symptoms persist or the patient cannot swallow, escalate to parenteral therapy.