How is symptomatic hypoglycemia managed in a patient with diabetes?

• A. Recheck glucose in 15 minutes and then give more insulin
• B. Administer 15-20 g fast-acting carbohydrate, recheck plasma glucose in 15 minutes; repeat if still low; follow with longer-acting carbohydrate
• C. Administer glucose infusion
• D. Provide only water and rest

Answer: (B)

When someone with diabetes develops symptomatic hypoglycemia, the priority is to raise the blood glucose quickly and then keep it stable. Start with a fast-acting carbohydrate that provides about 15–20 grams of glucose right away, such as glucose tablets, juice, regular soda, or candy. These options are absorbed rapidly and can reverse brain glucose shortage that’s causing symptoms.

Wait about 15 minutes and recheck the plasma glucose. If it’s still below the target (often around 70 mg/dL) or symptoms persist, give another rapid-acting carbohydrate dose and recheck again in 15 minutes. Once the glucose is back in a safe range, follow with a longer-acting carbohydrate snack or small meal to maintain the level and help prevent another drop as the body continues to process the sugar.

This approach targets both the immediate need to restore brain glucose and the longer-term goal of preventing recurrence. If the person cannot swallow or is unconscious, or if hypoglycemia is severe, different measures are used (such as intravenous glucose or glucagon) and urgent help should be sought.