Glucagon is a fast-acting hormone used to treat severe hypoglycemia, typically in people with diabetes who use insulin or certain other medications. This hormone, naturally produced by the pancreas, signals the liver to release stored glucose, known as glycogen, quickly into the bloodstream. Emergency glucagon is a synthetic form that serves as the standard rescue treatment when a person’s low blood sugar is so severe that they cannot safely consume sugar by mouth. It rapidly raises blood glucose levels to prevent complications like seizures or coma.
Recognizing Severe Hypoglycemia
The need for emergency glucagon is determined by the person’s functional status, not just a low blood sugar reading. Mild or moderate hypoglycemia (blood glucose typically below 70 mg/dL) can be treated with fast-acting oral carbohydrates like juice or glucose tablets, provided the person is fully conscious. Severe hypoglycemia is defined by the inability of the person to safely treat themselves and requires assistance from another person to recover.
Glucagon must be administered immediately if the person experiences an altered mental status or is unable to safely swallow food or liquid. This includes symptoms such as profound confusion, disorientation, or slurred speech, which indicate the brain is deprived of glucose. The most obvious indicators are loss of consciousness, unresponsiveness, or experiencing a seizure or convulsion.
Attempting to give an unconscious or semi-conscious person food or drink is dangerous because it creates a high risk of choking or aspiration. If the individual is unable to cooperate or swallow safely, the glucagon rescue medication is the only appropriate intervention. Caregivers, family, and friends should be educated on recognizing these specific symptoms and knowing where the emergency kit is stored.
How to Administer Emergency Glucagon
The procedure for administering glucagon depends on the specific device. Modern options come in several ready-to-use forms, such as pre-filled syringes, auto-injectors, and nasal powder devices, which are simpler than older kits requiring mixing. It is important to know the specific instructions for the device you own and to check its expiration date regularly.
For a nasal glucagon device, the powder form is removed from its packaging, and the tip is gently inserted into one nostril until the user’s fingers touch the outside of the nose. The plunger is then pushed firmly all the way in to deliver the single dose of powder. The medication is absorbed through the nasal lining and does not require the person to inhale it.
If using an auto-injector or pre-filled syringe, the injection is typically given into the thigh, upper arm, or stomach. These devices are designed for a straightforward, single-step administration. The user often pushes the device against the skin and holds it for a few seconds until the injection is complete. Unlike traditional kits, these do not require any mixing or drawing up of liquid.
Essential Follow-Up Care
After administering the glucagon, immediately call for emergency medical assistance, such as 911 or the local equivalent. While waiting for help, the person should be gently turned onto their side and placed in the recovery position. This positioning is a measure to prevent choking, as glucagon can sometimes induce nausea and vomiting as the blood sugar rises.
Glucagon typically begins to raise blood sugar within 10 to 15 minutes, and the person should regain consciousness. If there is no response or consciousness has not returned after 15 minutes, a second dose of glucagon may be administered, if a second device is available. Regardless of whether a second dose is given, medical help must continue to be waited for.
Once the person is fully awake and can safely swallow, it is crucial to provide a source of fast-acting carbohydrate, such as juice or regular soda. This step is necessary because the effect of the administered glucagon is temporary, lasting about 60 to 90 minutes. The body’s stored glucose used by the glucagon must be replaced. A small snack containing protein and fat, like crackers with cheese or peanut butter, should follow the fast-acting sugar to help prevent the blood sugar from dropping again.