How to Use Glucagon Rescue Medication

“Glucagon mainly helps increase blood glucose by signaling release of glucose stores from the liver,” says Joshua J. Neumiller, PharmD, CDCES, the president of healthcare and education at the American Diabetes Association.

During most episodes of hypoglycemia, an impaired glucose response system isn’t an emergency, because you have the time and ability to drink juice, eat candy, or otherwise consume the carbohydrates you need to raise your blood sugar levels.

“Glucagon is an important emergency medication for any person with diabetes taking insulin or otherwise at high risk for hypoglycemia,” says Dr. Neumiller.

Glucagon rescue medication comes in two different forms, injections and nasal sprays, both of which work by safely raising blood sugar, says Ammar Ahmed, MBBS, an assistant professor of diabetes, endocrinology, and metabolism at the University of Minnesota in Minneapolis.

“The main differences are how they are administered (nasal vs. injection) and how easily they can be used in an emergency,” says Dr. Ahmed.

Glucagon Nasal Spray

Glucagon Prefilled Syringes and Auto-Injectors

These premixed glucagon products work similarly to epinephrine (EpiPen), which is administered to someone experiencing a severe allergic reaction. These devices contain a stable glucagon solution that can be injected immediately when needed.

A prefilled syringe looks just like a regular syringe, with a needle on one end and a plunger on the other. Prefilled glucagon syringes don’t need any preparation, they are ready to inject as soon as they’re removed from their packaging.

Glucagon Injection Kits

People with long-standing diabetes may be familiar with these older kits, which have become less common as newer and more convenient options have hit the market in recent years.

“Glucagon should be given when someone with diabetes has severe low blood sugar and cannot safely eat or drink,” says Ahmed. “This includes when the person is unconscious, is having a seizure, or is awake but too confused or too drowsy to swallow.”

Glucagon is only rarely administered by the person who is experiencing low blood sugar. Generally, it must be given by a bystander who has been trained in its use.

Glucagon nasal sprays and premixed syringe and pens are designed to be easy to use in an emergency. They have streamlined instructions printed on their packaging, and the medicine can be administered in seconds. The older generation of injection kits, which require mixing the medicine before injecting it, take more work to prepare, but the instructions printed on the kit should be easy to follow.

After administering glucagon, Neumiller says to turn the person over on their side, since the medicine can cause vomiting, which is a choking hazard.

“If the person does not respond after 15 minutes of giving glucagon while waiting for EMS to arrive, another dose can be given, if available,” says Neumiller.

If you’ve called for emergency medical care, they will be able to advise whether or not the glucagon user needs to visit a hospital. If staying at home, Ahmed says to keep monitoring blood sugar levels over the next several hours, and to “contact the diabetes care team to review what caused the severe low and how to prevent it in the future.”

If you have diabetes, you’re unlikely to ever use glucagon on yourself. If you have the wherewithal to treat yourself with glucagon rescue medication, you probably also have the ability to find and consume a source of carbohydrates.

“It is helpful to print out instruction handouts and/or provide people close to you with links to videos that describe and show in detailed steps that should be taken during a hypoglycemia emergency,” he says.

Ahmed says that people with diabetes can write a simple action plan: “Keep a one-page guide with your name, diabetes type, medicines, where glucagon is stored, and your doctor’s phone number.”

Neumiller and Ahmed agree that it is critically important to store your glucagon where it can be accessed quickly and easily, and that the people who are close to you know where it is. During a severe hypoglycemic event, you may be unable to instruct your friends, family, or coworkers, and this medication will do no good if they don’t know how to find it.

Some glucagon products come in a standard two-pack, which gives you two units to place strategically: one at home and one in your office, for example, or perhaps one for the purse, backpack, or diabetes supply bag you always have with you.

Neumiller says glucagon products are generally designed to be stored at room temperature for up to one year, though you should check your product’s instructions, as specific storage and expiration information can vary.

• Glucagon rescue medications are lifesaving medications that are used during severe low blood sugar emergencies when people with diabetes have lost consciousness or cannot swallow normally.
• It is usually impossible for people with diabetes to use glucagon on themselves, which makes it necessary to teach friends, family, and coworkers when and how to use the medication.
• People with diabetes who take insulin or are at high risk for hypoglycemia should keep an emergency dose of glucagon on hand for use in case of a low-blood sugar emergency.