Glucagon for Severe Hypoglycemia

Hi, I'm Puff, the Keeper of Balance from the Fuzzle Friends! I was born from the steady hum of Mount Washington, where the sky knows how to hold still. My whole thing is the green range — that calm, steady place where everything hums along. Glucagon is what helps bring things back to balance when a low goes too far. Knowing what it is, how it works, and having it ready — that's how you protect the calm. And calm, I promise you, is worth protecting.

Low blood sugars can be a scary part of life with diabetes, but being informed and prepared on how to treat hypoglycemia can make these moments less stressful. Glucagon is the best treatment option for severe hypoglycemia.

What is glucagon?

Glucagon is a hormone that raises the level of glucose in the blood. The alpha cells of the pancreas, in areas called the islets of Langerhans, make glucagon when the body needs to put more sugar into the blood. Glucagon binds to a receptor on liver and muscle cells (called the glucagon receptor), stimulating the cells to release glucose. For people with type 1 diabetes, the pancreas does not release insulin, making them unable to adjust insulin levels in response to glucose levels, and type 1 diabetes can also impede the secretion of glucagon, making them at risk for severe low blood sugars.

Everyone who uses insulin should have a form of glucagon on hand at all times to counteract severe hypoglycemia that causes loss of consciousness, or if sugar cannot be given. See below for the kinds of glucagon that are available.

One of the potential side effects of a rescue dose of glucagon -- regardless of the form -- is vomiting, so be sure to place the person on his or her side prior to administering so they do not choke. After administering glucagon, follow with food once the person regains consciousness and is able to swallow.

Modern Glucagon Products

Families with type 1 diabetes have more choices than ever for glucagon products. These modern glucagon products are much easier to use than the old emergency glucagon kit. Discuss with your diabetes care team which of these is best for you.

BAQSIMI Nasal Glucagon

BAQSIMI, made by Eli Lilly, is the first and only dry nasal powder to treat severe hypoglycemia. Instead of an injection, BAQSIMI is administered as a puff in the nose. It is important to note that BAQSIMI can be given to a patient who unconscious, as it does not require being actively inhaled and can be used even if the patient has a congested nose. Keep tube sealed until ready to use.

How to dose BAQSIMI - image from the BAQSIMI website

GVOKE HypoPen

The GVOKE HypoPen, made by Xeris Pharmaceuticals, is the first premixed autoinjector for very low blood sugar. GVOKE contains stable liquid glucagon and is available as a HypoPen and as a pre-filled syringe. Using the GVOKE HypoPen is an easy, two-step process, shown below.