In Type 1 diabetes presenting with hypoglycemia and loss of consciousness, what is the appropriate treatment?

• A. Metformin
• B. Acarbose
• C. Insulin
• D. Glucagon

Answer: (D)

When severe hypoglycemia occurs in a person with Type 1 diabetes who is unconscious, the priority is to raise the blood glucose quickly. Because they cannot swallow, the immediate treatment is a glucagon injection. Glucagon acts on the liver to stimulate glycogen breakdown and gluconeogenesis, releasing glucose into the bloodstream within minutes, which can restore consciousness and correct the hypoglycemia promptly.

If available in a hospital setting or with IV access, intravenous dextrose (D50W) can be used, but glucagon is the classic emergency treatment when the patient cannot take carbohydrates by mouth. Insulin would worsen the situation by lowering blood glucose further, and the other oral agents (like metformin or acarbose) do not provide rapid, acute correction of hypoglycemia.