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Severe hypoglycaemia — SCE Endocrinology MCQ

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EasyDiabetesSevere hypoglycaemiaSCE Endocrinology

A 45-year-old man with type 1 diabetes is found unconscious at work. Capillary glucose is 1.8 mmol/L, intravenous access is not immediately available and he is unable to swallow. He takes basal-bolus insulin and has no known liver disease. What is the most appropriate management?

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

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Correct answer: E — Give intramuscular glucagon while obtaining intravenous access

Severe hypoglycaemia with impaired consciousness requires parenteral treatment; intramuscular glucagon is appropriate when IV access is unavailable. Oral carbohydrate is unsafe because of aspiration risk. The pearl is that recovery should be followed by longer-acting carbohydrate and review of the precipitant.

Reference: JBDS hypoglycaemia guideline, BNF