Hypoglycemia remains one of the most common causes of altered mental status encountered by prehospital providers and represents a significant proportion of emergency medical services (EMS) activations and refusals of transport. While rapid correction of hypoglycemia is often achievable in the field, the decision to transport or release patients after treatment remains controversial and varies across jurisdictions. This review synthesizes epidemiological data, pathophysiology of diabetes mellitus, types of therapeutic interventions, and evidence-based criteria guiding EMS treat-and-release protocols. Studies indicate that although many patients with corrected hypoglycemia may be safely managed without transport, a subset remains at risk for adverse outcomes, including hospital admission. Standardized clinical criteria and adherence to regional protocols are essential to ensure patient safety while reducing unnecessary healthcare utilization.

diabetes mellitus, hypoglycemia, emergency medical services, treat and release, prehospital care, transport refusal, EMS protocols.

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