What medication and dosage would you administer to an unresponsive, malnourished homeless patient with a low blood glucose?

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The key idea is delivering glucose quickly through the IV to reverse hypoglycemia in an unresponsive patient, especially when malnutrition is likely. Glucagon relies on stores of glycogen in the liver; in chronic malnutrition, those glycogen stores are often depleted, so glucagon may not raise blood glucose reliably. Oral glucose isn’t an option because the patient can’t swallow and protect the airway.

Giving dextrose intravenously raises blood glucose rapidly. Using a 10% dextrose solution as a bolus (a rapid, “wide open” administration) provides the necessary glucose quickly while reducing the osmolar burden compared with a more concentrated solution. A 50% dextrose bolus is more hyperosmolar and carries a higher risk of vein irritation or infiltration, especially if IV access isn’t perfect, and in malnourished patients that osmolar load can be more problematic. So the rapid IV dextrose approach with a 10% solution is preferred in this scenario to promptly correct hypoglycemia when the patient is unable to take oral glucose and glycogen reserves may be limited. After administration, reassess mental status and glucose level and monitor airway.