To which of the following diabetic patients should you administer oral glucose?

• A. A well-appearing 30-year-old diabetic patient
• B. A patient who is unconscious and cannot swallow
• C. A confused 55-year-old male with tachycardia and pallor
• D. A fully alert 70-year-old diabetic with normal mental status

Answer: (C)

In hypoglycemia, the priority is to raise the blood glucose quickly with a fast-acting carbohydrate when the patient is awake, oriented enough to swallow, and able to protect their airway. The described patient is confused (an altered mental status sign) but still likely able to swallow and is showing classic hypoglycemia signs like tachycardia and pallor. That combination makes oral glucose appropriate because it can be swallowed and will rapidly raise blood sugar to reverse neuroglycopenia.

The other scenarios aren’t suitable for oral glucose: an unconscious patient cannot swallow and needs IV dextrose or glucagon; a well-appearing patient who is not symptomatic may not need glucose; and a fully alert patient with normal mental status is unlikely to be experiencing hypoglycemia requiring urgent treatment with glucose.