If blood glucose is below 3.0 mmol/L, which action is indicated?

• A. Glucose
• B. Insulin
• C. Water
• D. Glucagon

Answer: (A)

When blood glucose falls to as low as 3.0 mmol/L, the brain is not getting enough fuel, so the priority is to raise the glucose level quickly with a fast-acting carbohydrate. The best action is to give glucose right away, such as glucose gel or a sugary drink that the patient can swallow. This rapidly increases blood glucose within minutes and helps reverse the symptoms of hypoglycemia that can impair thinking, speech, and coordination.

Giving insulin would make the situation worse by lowering blood glucose further, so it’s not appropriate here. Water alone won’t raise blood glucose and won’t correct the deficit quickly. Glucagon is reserved for situations where the person cannot take oral carbohydrates or is unconscious; in those cases an injection is used, but if the patient can safely swallow, oral glucose is preferred for a faster and simpler correction. After giving glucose, recheck the blood glucose after about 10 minutes and repeat if still low, then provide a longer-lasting carbohydrate to prevent a future drop.