Glucagon is a naturally occurring hormone produced in the pancreas that plays a central role in maintaining blood glucose levels within a healthy range. Its primary function in the body is to raise blood sugar when it drops too low, primarily by signaling the liver to release stored glucose. Beyond its natural function, synthetic glucagon is also used as a medication to address specific medical conditions.
Why Glucagon is Administered
Glucagon is administered as an emergency treatment for severe hypoglycemia, a condition characterized by dangerously low blood sugar levels. Severe hypoglycemia can manifest as an altered mental state, confusion, clumsiness, or an inability to eat or drink, and can lead to unresponsiveness, seizures, or loss of consciousness. Untreated severe hypoglycemia can lead to serious complications, including brain damage, organ damage, or, in rare cases, death. This medication is used when a person is unable to safely consume carbohydrates by mouth due to impaired consciousness or inability to swallow.
Forms of Glucagon Available
Glucagon is available in several formulations for emergency administration. One common form is injectable glucagon, which often comes as a kit containing a vial of powdered glucagon and a separate syringe filled with a diluting liquid. These components must be mixed together immediately before the injection. Another option is a pre-mixed, shelf-stable glucagon pen, which offers the convenience of being ready for immediate injection without prior mixing. Nasal glucagon is delivered as a powder through a pre-filled, single-dose device. This needle-free option is simpler to administer and is less intimidating for caregivers in an emergency.
Step-by-Step Glucagon Administration
Administering glucagon requires careful attention to the specific type of product being used.
Injectable Glucagon
For injectable glucagon that comes as a powder and liquid:
- Flip off the seal from the vial of glucagon powder.
- Remove the needle cover from the syringe and insert the needle into the rubber stopper on the vial.
- Inject the entire contents of the syringe into the vial of glucagon powder, then gently swirl the vial until the powder completely dissolves and the liquid becomes clear.
- Once mixed, draw the entire solution back into the syringe, preparing it for injection.
- The injection can be given into the buttock, outer mid-thigh, or upper arm muscle.
Nasal Glucagon
For nasal glucagon (e.g., BAQSIMIâ˘):
- Remove the shrink wrap by pulling the red stripe and open the lid to take the device out of the tube.
- Hold the device between your fingers and thumb, being careful not to press the plunger prematurely.
- Gently insert the tip of the device into one nostril until your fingers touch the outside of the nose.
- Once positioned, push the plunger firmly all the way in until the green line disappears, indicating the dose is complete.
Nasal glucagon does not require the person to inhale the medication for it to be absorbed and work effectively. Always refer to the specific instructions provided with the glucagon kit, as details can vary between brands.
What to Do After Glucagon is Given
After administering glucagon, turn the person onto their side. This position helps prevent choking if vomiting occurs, a common side effect of glucagon administration. Immediately call for emergency medical assistance, such as 911 or your local emergency services. Continue to monitor the person’s arousal, pulse, and respirations while waiting for help to arrive.
An unconscious person regains consciousness within 15 minutes of receiving glucagon. If the person does not awaken within this timeframe, a second dose of glucagon is necessary if available. Once the person is awake and able to swallow safely, provide a fast-acting source of sugar, such as fruit juice, a regular soft drink, or glucose tablets. Follow this with a longer-acting carbohydrate source, like crackers and cheese or half a sandwich, to help prevent blood sugar from dropping again. Also check the person’s blood sugar hourly for about 3 to 4 hours after they regain consciousness.