Final answer:
If a hypoglycemic patient does not respond to glucagon, IV administration of dextrose is the next step. This management is based on the understanding that the patient may have depleted glycogen stores or an inability to mobilize glycogen, indicating the need for direct glucose replenishment.
Step-by-step explanation:
If a hypoglycemic patient does not improve after administration of glucagon, and an intravenous (IV) line has been established, the next step typically involves providing a dextrose solution. Often, a bolus of 10-25 grams of dextrose is given intravenously to rapidly increase blood glucose levels. In clinical settings, dextrose 50% in water (D50W) is a common formulation used for this purpose. It is critical to monitor the patient's blood glucose levels closely after administration to ensure that they return to and maintain a safe range. If glucagon is not effective, this might be an indication of depleted glycogen stores in the liver, and direct glucose administration is necessary.
It is also important to understand the underlying mechanisms of hypoglycemia in the patient. As indicated by Graph-A and related information, a glucagon tolerance test can help determine whether a diabetes patient is insulin-independent with defective insulin receptors, or if their condition is due to excessive insulin antagonists. A lack of response to glucagon suggests a deficiency in glycogen stores or an inability to mobilize glycogen, which could be due to liver disease or other metabolic issues.