In an uncooperative/unresponsive patient with suspected hypoglycemia, which action is indicated first?

• A. Sugary drink
• B. IM glucagon injection
• C. Insulin injection
• D. CPR

Answer: (B)

When someone is unresponsive and hypoglycemia is suspected, the priority is to raise the blood glucose quickly without needing the patient to swallow. Oral sugars aren’t safe here because the person can’t protect their airway, so you need a fast-acting treatment that works without cooperation. Intramuscular glucagon does exactly that: it stimulates the liver to release stored glucose (glycogenolysis and gluconeogenesis), typically lifting blood sugar within minutes. This makes it the best first step in this scenario, especially if IV access isn’t readily available. If an IV line is already in place, giving glucose intravenously is also appropriate and acts even faster, but the essential idea is to treat the hypoglycemia now rather than offering oral sugar. Avoid giving a sugary drink because of risk of aspiration, and avoid insulin which would worsen the situation. If the person remains unresponsive after the glucagon, seek urgent help and reassess airway, breathing, and circulation.