A patient develops hypoglycemia. He was on insulin and acarbose. For treatment of above what is to be given?
**Core Concept**
The patient's hypoglycemia is a result of an imbalance between insulin and glucose levels, with the insulin causing excessive glucose uptake and utilization. Acarbose, a glucosidase inhibitor, further inhibits glucose absorption in the gut.
**Why the Correct Answer is Right**
In this scenario, the patient needs a rapid-acting glucose source to counteract the hypoglycemic effect of insulin. Glucagon is the ideal choice as it stimulates glycogenolysis and gluconeogenesis, thereby increasing blood glucose levels. Glucagon acts through the glucagon receptor (GCGR) in the liver, stimulating the enzyme glucose-6-phosphatase to convert glucose-6-phosphate to glucose, which is then released into the bloodstream.
**Why Each Wrong Option is Incorrect**
**Option A:** Glucagon-like peptide-1 (GLP-1) analogs, such as liraglutide, would further lower blood glucose by inhibiting glucagon secretion and enhancing insulin secretion.
**Option B:** Octreotide, a somatostatin analog, would inhibit the release of glucagon and insulin, exacerbating hypoglycemia.
**Option C:** Sodium polystyrene sulfonate (SPS) is used to treat hyperkalemia by exchanging potassium ions for sodium ions in the colon, and it is not effective in treating hypoglycemia.
**Clinical Pearl / High-Yield Fact**
Glucagon is the treatment of choice for insulin-induced hypoglycemia, particularly in patients with diabetes who are taking insulin or sulfonylureas.
**Correct Answer: A. Glucagon. Glucagon is the treatment of choice for insulin-induced hypoglycemia.**