For a diabetic patient with a BGL below 60 who cannot swallow, what is the primary treatment?

The primary treatment for a diabetic patient with a blood glucose level below 60 who cannot swallow is the administration of dextrose intravenously, specifically dextrose 10% given in a volume of 250 mL. This is because patients who are unable to swallow represent a significant risk for aspiration if oral glucose is administered. Providing glucose directly into the bloodstream via intravenous administration allows for rapid elevation of the blood glucose level, which is crucial in preventing severe neurological damage or loss of consciousness due to hypoglycemia.

Dextrose 10% is specifically formulated for this purpose and can effectively treat hypoglycemia in emergency situations. It delivers an appropriate concentration of glucose that is quickly metabolized by the body, making it a safe and effective option for those unable to take oral medications or nutrients.

Other options mentioned, such as oral glucose or glucose tablets, pose a danger for aspiration and are not suitable for patients who cannot swallow. IV fluids alone, while potentially helpful in other scenarios, do not directly address the immediate need for glucose replacement in a hypoglycemic state.