- There are two types of glucagon injection: one you mix just before injecting, and one that’s premixed in an auto-injector.
- In case of severe hypoglycemia, you may not be able to administer glucagon yourself, so friends and family should be taught how.
- Always get emergency medical assistance or consult with your doctor after using glucagon.
When your blood sugar is a little low, a condition known as hypoglycemia, you can usually treat it with high-sugar foods or glucose tablets. The condition commonly occurs in people with diabetes. But severe hypoglycemia is life threatening.
One way to quickly reverse dangerously low blood sugar is with a glucagon injection. Glucagon is a hormone that helps stabilize blood sugar levels.
Read on to learn how to recognize hypoglycemia in someone else, how to administer glucagon, and what you need to know in an emergency.
A glucagon injection is an emergency medical device for people with type 1 diabetes. It’s used to treat severely low blood sugar.
The injections are designed so you can carry them with you and administer them yourself. But you do need a doctor’s prescription. Glucagon injections come in two forms:
- A kit containing a powder and liquid you mix just before injecting.
- A ready-to-use prefilled syringe and auto-injector device.
In the event of severe hypoglycemia, you may not be able to give yourself an injection. It’s a good idea to teach those closest to you what hypoglycemia looks like, where you keep your glucagon, and how to administer it.
With this type of glucagon kit, you have to premix the medicine before you can inject it. Even so, it should only take a minute or two. Here are the basic steps:
- Open the kit. Take the cap off the vial of powder, then remove the cap on the syringe.
- Insert the needle into the rubber stopper on the vial.
- Push the plunger on the syringe to inject the liquid into the powder.
- Keeping the needle in the vial, flip so that the vial is on top.
- Gently swirl until all the powder is dissolved and the solution is totally clear.
- With the vial still on top, pull the plunger out of the syringe back and draw all the liquid into it.
Now you’re ready to inject the medicine into the thigh, buttock, or upper arm. Here are the steps:
- Clean the injection site with an alcohol swab, if available.
- Insert the needle straight into the skin (not at an angle), quickly and in one motion.
- Using your thumb, push the plunger all the way until all the medicine has been injected.
- Remove the needle by pulling straight out.
- If you have an alcohol swab, press it against the injection site.
- Turn the person onto their side in case they vomit.
If you mix the medicine, but don’t use it, throw it away. Mixed medicine can’t be used later.
This type of injection doesn’t require much in the way of preparation. But don’t open the pouch until you’re ready to administer the glucagon. If you open it but don’t use it, it must be discarded.
Here’s how to administer glucagon with a prefilled auto-injector:
- Open the pouch and make sure the medicine looks clear and almost colorless. If it’s cloudy or has visible particles, don’t use it.
- If alcohol is available, clean the injection site.
- Inject into the skin of the lower abdomen, thigh, or upper arm.
- Hold for 5 seconds, then release.
- Turn the person on their side.
What not to do
When someone is experiencing hypoglycemia and is losing consciousness, it’s a life threatening situation. Call 911 if you don’t know what to do or there’s no glucagon available. If the person stops breathing and has no pulse, perform CPR.
In the meantime, do not:
- Try to put food or fluids in their mouth because this can lead to choking.
- Inject insulin, because they already have low blood sugar and this will lower it even more.
- Use expired glucagon.
After administering glucagon
Immediately after injecting someone with glucagon, call for emergency medical assistance.
If possible, check to see if their blood sugar level is at least 70 milligrams per deciliter (mg/dL). Someone who was unconscious should wake up within 5 to 20 minutes of getting the glucagon. Once they’re awake and alert, provide fruit juice, non-diet soda, or oral carbohydrates while you wait for help.
Even if they regain consciousness, they should still consult with their doctor.
If the person hasn’t regained consciousness within 15 to 20 minutes and help hasn’t arrived, you can give a second dose of glucagon, if available. If the person stops breathing, perform CPR.
Side effects may include:
- irritation at the injection site
- rapid heartbeat
Signs of allergic reaction can include:
- skin rash
- difficulty breathing
- loss of consciousness
Hypoglycemia can be life threatening. Being prepared for this complication is crucial. But people with type 1 diabetes can’t always tell they have hypoglycemia, especially if they’ve had diabetes for a long time.
That’s why it’s important that loved ones are aware of the warning signs and know what to do in case of emergency. Signs that someone is experiencing hypoglycemia include:
- shakiness, weakness, or tiredness
- nervousness, irritability, or impatience
- sweating, chills, or pale skin
- dizziness, clumsiness, or confusion
- crying out during sleep
Severe hypoglycemia can cause:
- inability to cooperate with efforts to help
- loss of consciousness
Glucagon doesn’t need refrigeration. Room temperature is best.
Avoid storing it where young children can get to it. Make sure that people who can administer the medicine know where you keep it.
Consider storing kits where you spend a lot of time, such as:
- school or dorm
- homes of friends and relatives you visit often
Keep in mind that glucagon should not be exposed to extreme temperatures or direct sunlight. But there may be circumstances where you can carry a kit in your car, backpack, or satchel.
Keep an eye on expiration dates and replace as needed.
A glucagon injection is a potentially lifesaving device for people with type 1 diabetes. It’s only available by prescription. You can get a kit with powder and liquid that you mix just before injecting, or a prefilled syringe with auto-injector.
Store kits in a few key places so they’re there when you need them. To prepare for emergencies, teach those closest to you how to recognize hypoglycemia and administer glucagon.