A 22-year-old male has a blood glucose of 46 mg/dL. After dextrose 50%, he is alert and oriented but refuses transport and states he started a new type of insulin. What is the appropriate action?

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After treating hypoglycemia with dextrose, the patient still needs medical evaluation, especially when a new insulin type has been started. Hypoglycemia can recur, and changes in insulin regimens can hide dosing mistakes, missed meals, or other factors that affect glucose control. A physician can reassess the insulin plan, review recent meals and activity, check for signs of continued instability, and make appropriate adjustments to prevent another episode.

Even though he is now alert and oriented, he has decision‑making capacity and may choose not to be transported. Your role is to explain the importance of medical evaluation at this time and encourage hospital assessment, documenting the discussion and the patient’s understanding. If he remains unwilling, you would follow local protocols for patient refusal, but not administer additional glucose or force transport without indication.