A 63-year-old male with diabetes is unresponsive and has a blood glucose of 26 mg/dL. IV access cannot be established. What is the appropriate treatment?

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When a diabetic patient is unresponsive with a blood glucose of 26 mg/dL, the priority is to rapidly raise blood sugar. If IV access cannot be established, intramuscular glucagon is the best option because it signals the liver to release stored glucose (glycogenolysis), usually producing a rise in blood glucose within minutes. Dextrose given IV would be the ideal treatment, but that isn’t possible here due to the lack of IV access. Oxygen therapy helps oxygen delivery but doesn’t fix hypoglycemia. Intravenous fluids won’t promptly correct a severely low glucose level. Glucagon is chosen specifically for this scenario because it can be given without an IV line and can swiftly counteract the hypoglycemia. If the patient doesn’t respond quickly (or if hepatic glycogen stores are depleted), prepare to establish IV access and administer IV dextrose as soon as possible.