Severe Hypoglycaemia Glucagon — RACP Adult Medicine MCQ

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EasyEndocrinologySevere Hypoglycaemia GlucagonRACP Adult Medicine

A 30-year-old man with type 1 diabetes presents with severe hypoglycaemia (glucose 1.8 mmol/L) causing seizure and loss of consciousness. He lives alone. His partner found him unconscious and called an ambulance. He has no IV access. What is the most appropriate emergency treatment?

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Correct answer: E — IM glucagon 1 mg

Severe hypoglycaemia with loss of consciousness and no IV access = IM glucagon 1 mg (or intranasal glucagon 3 mg if available). Glucagon mobilises hepatic glycogen stores, raising blood glucose within 10-15 minutes. All T1DM patients (and insulin-treated T2DM patients) should have a glucagon kit at home and their family/carers should know how to administer it. Once conscious: oral carbohydrate. Investigate cause: insulin dose error, missed meal, exercise, alcohol, gastroparesis.

Reference: ADS – 2024 – Hypoglycaemia; eTG Endocrine 2024