Glucagon is a hormone produced naturally by the pancreas that plays a central role in regulating blood sugar levels. It works primarily by signaling the liver to release stored glucose, known as glycogen, into the bloodstream. This action helps to raise blood sugar when it drops too low. In emergency situations, manufactured glucagon is used as a medication to treat severe low blood sugar, a condition also known as severe hypoglycemia. It provides a rapid way to increase glucose levels in the body when an individual cannot consume sugar by mouth.
Glucagon Administration Routes
Glucagon can be administered through different routes, including intramuscular (IM) injection, subcutaneous (SQ) injection, and in some newer formulations, as a nasal spray. An intramuscular injection involves delivering the medication directly into a muscle, such as the outer thigh, upper arm, or buttocks. This route allows for relatively quick absorption into the bloodstream due to the rich blood supply in muscle tissue.
A subcutaneous injection involves injecting the medication into the fatty tissue just beneath the skin, commonly in areas like the stomach, thigh, or upper arm. While both IM and SQ routes are effective, studies suggest that for increasing blood glucose levels, there is no significant difference in efficacy between the two methods. Older kits may require mixing a powder with a liquid, while newer formulations like pre-mixed pens or auto-injectors are ready to use. These devices may be designed for either SQ or IM administration. The specific product instructions should always be followed to ensure proper administration.
Recognizing Severe Hypoglycemia
Recognizing severe hypoglycemia is important for timely intervention with glucagon. This condition occurs when blood sugar levels drop dangerously low, typically below 70 mg/dL, and the individual cannot self-treat. Symptoms often indicate significant mental or physical impairment, including confusion, disorientation, slurred speech, or an inability to complete routine tasks.
They may also exhibit clumsiness, loss of coordination, or extreme weakness, preventing safe oral intake. The individual might become unconscious, have a seizure, or enter a coma. Prompt action is necessary because prolonged severe hypoglycemia can lead to serious complications, including brain damage or death.
Steps for Glucagon Administration
Administering glucagon requires careful adherence to the product’s specific instructions, as formulations can vary. Before use, it is important to check the expiration date on the kit and ensure the solution is clear and free of particles after mixing, if mixing is required. The first step in an emergency is to call for emergency medical help immediately after recognizing severe hypoglycemia.
For kits requiring mixing, this involves injecting a pre-filled syringe of sterile water into a vial containing glucagon powder, then swirling or shaking until dissolved. Draw the prepared solution back into the syringe. Choose an injection site like the outer thigh, upper arm, or buttocks. Insert the needle at a 90-degree angle and push the plunger to deliver the dose. After injection, remove the needle and apply light pressure if needed.
Post-Administration Care
After administering glucagon, it is important to turn the person onto their side. This position helps to prevent choking if nausea or vomiting occurs, a common side effect. The person should regain consciousness within 15 minutes of the injection. If there is no response within this timeframe, a second dose may be administered if instructed by a healthcare provider, while awaiting medical assistance.
Once the person awakens and is able to swallow safely, provide them with a fast-acting source of sugar, such as fruit juice or glucose tablets. This should be followed by a longer-acting carbohydrate source combined with protein, like crackers and cheese or a sandwich, to replenish glucose stores and prevent blood sugar from dropping again. Continue monitoring the person and ensure they receive professional medical evaluation, even if they recover quickly. This helps determine the cause of the low blood sugar and adjust their diabetes management plan if necessary.