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Glucose conscious hypoglycaemia — DipIMC MCQ

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ModeratePharmacology in Pre-Hospital SettingGlucose conscious hypoglycaemiaDipIMC

A 58-year-old man with type 1 diabetes becomes sweaty and confused at a sports event. He is sitting upright, can swallow safely and capillary glucose is 2.4 mmol/L. He has no IV access and is becoming irritable. What is the most appropriate immediate action?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: C — Give fast-acting oral glucose and reassess

Option C is correct because A conscious patient who can swallow should receive fast-acting oral glucose with repeat capillary glucose assessment. Intramuscular glucagon or IV glucose is reserved for patients unable to take oral carbohydrate or where oral treatment fails. The practical point is to correct hypoglycaemia promptly while avoiding aspiration risk. Option B is less appropriate because oxygen may be supportive, but it does not address the defining time-critical problem first; option E is less appropriate because vascular access is useful, but it should not delay the immediate priority. Option D is less appropriate because it is plausible in a different scenario but suboptimal for the features described; option A is less appropriate because delay would increase clinical risk. Clinical pearl: in DipIMC-style questions, the best answer is the intervention that changes outcome earliest in the pre-hospital phase.

Reference: JRCALC Guidelines; NICE CKS Hypoglycaemia