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All unconscious patients should be treated for presumptive hypoglycemia with an injection of D50. Once the patient is conscious, glucose is given by mouth to attain the desired glucose level. The rescue therapy is followed by a carbohydrate and protein snack to maintain the desired level.
The stabilized patient's immediate past history should be reviewed, looking for triggering factors. The patient and family can then be taught ways to avoid such situations in the future or to manage them before hypoglycemia again becomes this serious. If insulin levels need to be adjusted, the patient's preprandial glucose levels for the preceding 24 hr must be reviewed. The patient and family are assisted in processing the event. Their treatment actions are given positive reinforcement, correcting any errors such as inability to recognize early symptoms of insulin shock, overcorrection of insulin deficiency, or use of food products that are absorbed too slowly.