A patient with diabetes presents awake with cool, pale and sweaty skin. The home glucometer shows a low reading and the patient can safely swallow. What should you give this patient?

• A. A piece of candy.
• B. 15 to 20 grams of sugar, ideally in glucose tablets.
• C. 2 cups of fruit juice.
• D. A full meal.

Answer: (B)

When a patient with diabetes is awake, can swallow, but is showing signs of hypoglycemia (cool, pale, sweaty, low reading), the priority is a rapid rise in blood glucose with fast-acting carbohydrate. About 15–20 grams of carbohydrate acts quickly to raise glucose levels to a safer range. Glucose tablets are ideal because they provide a precise, fast-acting dose that’s easy to dose and swallow.

A piece of candy can work but doesn’t guarantee the exact 15–20 g dose. Two cups of fruit juice deliver far more than needed and can cause a larger-than-necessary spike. A full meal won’t help fast enough to treat the current hypoglycemia.

After administration, recheck blood glucose in about 15 minutes and repeat if still low. Once stabilized, follow with a small snack if needed to maintain a normal level and prevent recurrence. If the patient cannot swallow or becomes unconscious, seek emergency help and use alternate treatments like glucagon as indicated.