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 use Nasal Glucagon BAQSIMI®►
How to use Gvoke Hypopen®►
How to use ZEGALOGUE®►
How to use Glucagon Emergency Kits (GEK)►
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 severe hypoglycemia (low blood sugar) and cannot take sugar orally or in non-emergency situations with mini-dosing to prevent “glycemic overshoot.” 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. It comes in several forms including a nasal spray, auto-injectors, prefilled syringes, or a powder that must be mixed with a liquid before injecting.
Types of Emergency Glucagon
While there was only one option for decades — and it was complicated to use — there are many new and improved emergency glucagon treatment products available today, including:
- Nasal glucagon – Baqsimi®: This is an emergency glucagon that’s administered through your nose.
- Glucagon pen – Gvoke HypoPen®: This is a premixed glucagon injection that you press against your thigh. The auto-inject device makes it quick and easy to use. It is also available in a prefilled syringe (PFS).
- Glucagon vial & syringe – Gvoke Kit®: This is a premixed glucagon in a vial that comes with a syringe, allowing you to draw up the dose manually and inject it directly into your thigh.
- Glucagon pen – Zegalogue®: Also a premixed glucagon, available as an easy-to-use auto-inject device. It is also available in a prefilled syringe (PFS).
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?
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 nasal glucagon to the nostril. If hospitalized, an injection may be given intravenously. Always contact emergency services if glucagon is administered in an emergency situation.
In cases of hypoglycemia (low blood sugar), glucagon allows the body to release sugar into the blood stream, so blood glucose levels can 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 may not work effectively if a person has been consuming alcohol.
How to store glucagon?
When not in use glucagon should be stored at room temperature. Do not freeze or refrigerate and keep away from direct sunlight. If using for mini-dosing, opened 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