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학습 자료 둘러보기 →A blood glucose level below 50 mg/dL with symptoms like confusion or diaphoresis indicates severe hypoglycemia and constitutes a medical emergency. The brain's dependence on continuous glucose supply means neuronal dysfunction occurs rapidly, and prolonged neuroglycopenia can lead to irreversible brain injury.
The immediate priority is to administer a rapid-acting carbohydrate source. For a patient with altered consciousness who can swallow safely, give 15-20 grams of oral glucose. If the patient is confused or has a depressed gag reflex, administer 25-50 mL of 50% dextrose (D50) intravenously or 1 mg of intramuscular glucagon.
Patients with chronic kidney disease are at high risk for prolonged hypoglycemia due to reduced renal gluconeogenesis and impaired insulin clearance. Recheck blood glucose 15 minutes after treatment and monitor closely for rebound hypoglycemia, especially in those with heart failure where volume from D50 administration must be considered.
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