Editor’s Note: This content has been verified by Marina Basina, MD, a Clinical Associate Professor at Stanford University. She’s a clinical endocrinologist and researcher with a focus on diabetes management and diabetes technology. Dr. Basina is an active member of multiple medical advisory boards and community diabetes organizations, and she is on the Beyond Type 1 Science Advisory Council.
How to administer Nasal Glucagon BAQSIMI►
How to administer Injectable Glucagon►
Gvoke — Liquid Stable Glucagon from Xeris►
What is glucagon?
Besides being a hormone that occurs naturally in the body, glucagon is also an emergency medicine used when a person with diabetes is experiencing hypoglycemia and cannot take sugar orally or in non-emergency situations with mini-dosing to prevent “glycemic overshoot.” It comes in powder form and must be added to a solution in order to administer it. Once injected, it raises the blood sugar by sending a signal to the muscles and liver (where glucose is stored in your body).The effect of glucagon is opposite of the effect of insulin, raising blood sugar instead of lowering it. As of August 2019, Nasal Glucagon BAQSIMI is also available in the U.S. for treatment of patients age 4 and older. This powder form of glucagon is administered into the nose, and comes in a single-use dispenser.
What is the difference between glucagon and insulin?
In people with a fully functional pancreas, insulin and glucagon work in tandem to keep blood sugars stable. Insulin lowers blood sugar, while its partner, glucagon, releases the body’s glucose reserves from the liver to raise blood sugars.
When do you use glucagon?
In emergencies –
If you are conscious but cannot consume sugar orally, you can self-administer glucagon. If you are unconscious, someone else will need to inject the glucagon into muscle, or administer BAQSIMI to the nostril. If hospitalized, an injection may be given intravenously. Always contact emergency services if glucagon is administered in an emergency situation.
In management –
In cases of hypoglycemia (low blood sugar), glucagon allows the body to release sugar into the blood stream, so BGLs elevate to a safer range. Consult a physician to see if it would be helpful to use glucagon in glycemic overshoot prevention. It is important to note that glucagon will not work effectively if a person has been consuming alcohol.
How to store glucagon?
When not in use, (ie still in powder form) the glucagon kit or BAQSIMI inhaler should be stored at room temperature. Do not freeze or refrigerate and keep away from direct sunlight. If using for mini-dosing, mixed glucagon can be stored in the refrigerator for 24 hours.
What can cause hypoglycemia?
- Too much insulin causing an “insulin reaction”
- Not eating when scheduled to eat
- Being sick (excessive vomiting or diarrhea)
- Excessive exercise
What are symptoms of hypoglycemia?
- anxious feeling
- behavior change similar to being drunk
- blurred vision
- cold sweats
- cool pale skin
- difficulty in concentrating
- excessive hunger
- fast heartbeat
- restless sleep
- slurred speech
- unusual tiredness or weakness
Untreated hypoglycemia will cause convulsions (seizures), unconsciousness and possibly death.’
Possible side effects of glucagon:
- itchy skin
- allergic reaction
- increased blood pressure
- increased pulse
If the following occur, call your physician immediately:
- difficulty breathing