Mini-dosing of Glucagon in Everyday Diabetes Management
1/20/17
WRITTEN BY: Pamela Hoffman, MPH
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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. It comes in powder form and must be added to a solution in order to administer it. The effect of glucagon is opposite of the effect of insulin, raising blood sugar instead of lowering it.

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.

Glucagon and Type 1 diabetes

In contrast, people with Type 1 diabetes currently have only synthetic insulin available in their diabetes management toolkit to lower their blood sugar, and they must rely solely upon sugar-containing food sources to raise their blood sugar. Most people who are insulin-dependent keep a glucagon rescue kit handy in case of an extreme (and life-threatening) case of hypoglycemia, but mostly individuals with Type 1 feel grateful when they notice the kit collecting dust, unused.

Glucagon in Type 1 diabetes management

If the body uses glucagon naturally, can people with Type 1 benefit from using glucagon in non-emergency situations? The following are situations where mini-dosing of glucagon may be helpful in management.

Sick days

It turns out that glucagon kit can come in mighty handy on sick days, when nausea and vomiting make eating and drinking nearly impossible and increased insulin sensitivity can cause blood sugars to fall rapidly. In the past decade, diabetes practitioners have become more comfortable with developing guidelines for administering small doses of glucagon (the “mini-dose”) to help with sick day management.

*See the below-referenced article by Haymond and Schreiner (2001) and the links to printable PDFs for glucagon dosing guidelines according to age, but, as with all things diabetes-related, ask your endocrinologist about his or her recommendations as well.

Always consult your physician for proper dosing. Mini-Dose Glucagon Rescue Protocol:

Substitute for sugars

Another potential benefit of using mini-doses over sugary snacks to treat hypoglycemia is that mini doses may prevent “glycemic overshoot,” or the tendency to overtreat low blood sugars with too many additional carbohydrates (Haymond, Redondo, McKay, et al., 2016).

Some adults and athletes with Type 1, who can struggle to maintain tight blood sugar control and nutrition goals, may wish they didn’t have to rely on glucose tablets, juices, and sugary snacks to correct their lows.

Parents of children with Type 1 may desire a more reliable method than snacks to raise their child’s low blood sugar during athletic events, or in the middle of the night when their child is asleep and difficult to wake up.

The problem with Glucagon in its current state

The current formulations of glucagon found in rescue kits prevents more casual use for the following reasons:

  • Its very limited shelf life once mixed (about 24 hours)
  • The inconvenient mechanics of dissolving the powdered glucagon into a liquid solution
  • The limited knowledge on the proper glucagon dosage by age and weight
  • The expense of the kits

The G-Pen Mini

The G-Pen Mini made by Xeris Pharmaceuticals has been working to obtain FDA approval for a ready-mixed, stable, long-lasting glucagon formula available in smaller doses, called the G-Pen Mini. The glucagon can last for up to two years at room temperature and will be marketed for use by individuals with either Type 1 or Type 2 diabetes.

The G-Pen Mini is currently in Phase 2 trials. (See referenced article by Haymond, Redondo, McKay, et al., 2016 for the latest published research on mini-dose glucagon.) If this, or a similar product, is approved, someday every diabetes toolkit may include a quick, user-friendly, and non-caloric way to remedy low blood sugars.

The closed-loop artificial pancreas system

The Beta Bionic’s iLet system, (awaiting FDA approval), not only gives automatic dosing of insulin but also of glucagon, the vital hormone for bringing blood sugar up and preventing potentially life-threatening hypoglycemia. Created by Ed Damiano, a professor of biomedical engineering at Boston University, this device is proposed to be the ultimate artificial pancreas, able to administer correction doses 24/7 for both hyperglycemia and hypoglycemia. Trials for the iLet device begin fall of 2017 and will be more extensive with the addition of the hormone glucagon.


References –

Haymond, M. W., Redondo, M. J., McKay, S., Cummins, M. J., Newswanger, B., Kinzell, J., & Prestrelski, S. (2016, March). Nonaqueous, Mini-Dose Glucagon for Treatment of Mild Hypoglycemia in Adults With Type 1 Diabetes: A Dose-Seeking Study, Diabetes Care, 39(3), 465-468. Retrieved January 18, 2017.

Haymond, M. W., & Schreiner, B. (2001, April 24). Mini-Dose Glucagon Rescue for Hypoglycemia in Children With Type 1 Diabetes, Diabetes Care, 24(4), 643-645. Retrieved January 18, 2017.

Idlebrook, C. (2016, July 22). Glucagon the Sole Focus of a Bionic Pancreas Trial, Insulin Nation. Retrieved January 19, 2017.

Leach, C. (2013, July 17). Harnessing Hypos: Glucagon As An Everyday Tool, Insulin Nation. Retrieved January 18, 2017.


Read All About Glucagon and What Saved My Son’s Life by Bonnie On’Neil.

Pamela Hoffman, MPH

Pamela Hoffman, MPH, is a freelance writer, blogger, and public health researcher living in Minneapolis, MN with her husband and two sons. Type 1 diabetes has been a big part of her life since her older son was diagnosed at age 2. When she has spare time, Pamela enjoys cooking, hiking and biking with her family and friends, home décor, traveling, and reading. You can read more of Pamela’s blog posts at: http://withhugsandquiches.com.