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Severe hypoglycaemia — SCE Acute Medicine MCQ

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EasyDiabetes and endocrine medicineSevere hypoglycaemiaSCE Acute Medicine

A 31-year-old man with type 1 diabetes is brought in unconscious. Capillary glucose is 1.8 mmol/L. IV access is difficult despite two attempts, and he is having brief generalised jerks. What is the most appropriate immediate treatment?

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

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Correct answer: A — Give intramuscular glucagon while obtaining definitive IV access

Severe hypoglycaemia with reduced consciousness requires immediate glucose replacement. If IV access is not available, IM glucagon is appropriate while access is obtained for IV glucose if needed. Oral glucose gel is unsafe in an unconscious patient due to aspiration risk.

Reference: JBDS Hypoglycaemia Guideline; BNF Glucagon