From the Guidelines
Glucagon should be administered to treat severe hypoglycemia in patients who are unconscious or unable to consume oral glucose, as it rapidly raises blood sugar levels by stimulating the liver to convert stored glycogen into glucose. This is based on the recommendations from the American Diabetes Association, as outlined in the 2017 standards of medical care in diabetes 1. The standard dose is 1 mg for adults and 0.5 mg for children under 25 kg, given by intramuscular, subcutaneous, or intravenous injection.
Key Points to Consider
- Glucagon administration is not limited to healthcare professionals, and caregivers or family members should be instructed on its administration 1.
- Patients at increased risk for clinically significant hypoglycemia should have a glucagon emergency kit available, and family members should be trained in its use 1.
- After administration, the patient should be placed in the recovery position and monitored for blood glucose levels, with additional doses given if necessary 1.
- Glucagon works by stimulating the liver to convert stored glycogen into glucose, rapidly raising blood sugar levels, and its effect typically begins within 8-10 minutes and lasts 12-27 minutes.
Prevention and Management
- Prevention of hypoglycemia is critical in type 1 diabetes management, and self-monitoring of blood glucose and continuous glucose monitoring (CGM) are important tools to monitor glucose levels and prevent hypoglycemia 1.
- Patients should be educated about times when they may be at increased risk for hypoglycemia, such as while fasting for tests, with delayed meals, during or after exercise, and during sleep 1.
- Hypoglycemia unawareness or one or more episodes of severe hypoglycemia should trigger reevaluation of the treatment regimen, and insulin-treated patients with hypoglycemia unawareness or an episode of severe hypoglycemia should be advised to raise their glycemic targets to strictly avoid further hypoglycemia for at least several weeks 1.
From the FDA Drug Label
2 DOSAGE & ADMINISTRATION 2. 1 Important Administration Instructions for Using the Glucagon Emergency Kit for Low Blood Sugar to Treat Severe Hypoglycemia
Glucagon for Injection is for subcutaneous, intramuscular, or intravenous injection. Administer intravenously ONLY under medical supervision. Instruct patients and their caregivers on the signs and symptoms of severe hypoglycemia Because severe hypoglycemia requires the help of others to recover, instruct the patient to inform those around them about Glucagon for Injection and its Instructions for Use. Administer Glucagon for Injection as soon as possible when severe hypoglycemia is recognized
The main reason to administer glucagon (Glucagon) is to treat severe hypoglycemia. Key points include:
- Administering glucagon as soon as possible when severe hypoglycemia is recognized
- Informing patients and their caregivers about the signs and symptoms of severe hypoglycemia
- Providing instructions for use to patients and caregivers
- Administering intravenously only under medical supervision 2
From the Research
Administration of Glucagon
The administration of glucagon is a crucial aspect of managing hypoglycemia, a life-threatening condition that can occur in individuals with diabetes. The following points highlight the importance and benefits of administering glucagon:
- Glucagon is an emergency medication that can quickly raise glucose levels in individuals who are unconscious or unable to consume glucose due to severe hypoglycemia 3
- The traditional formulation of glucagon required reconstitution of a dry powder with diluent immediately prior to injection, which can be cumbersome and may lead to underutilization 3
- New formulations of glucagon, such as nasal powder glucagon and liquid-stable glucagon, have become available, which are easier to use and more convenient than traditional formulations 4, 3
- These new formulations have been shown to be effective and safe in treating severe hypoglycemia, with a similar tolerability profile to traditional glucagon formulations 5
Benefits of Glucagon Administration
The administration of glucagon has several benefits, including:
- Rapid increase in blood glucose levels, which can help to prevent medical sequelae of severe hypoglycemic emergencies 5
- Easy to use and administer, especially in emergency situations, which can help to improve outcomes and reduce the risk of complications 4, 3
- Can be used in a variety of settings, including out-of-hospital settings, which can help to empower patients and their families to manage hypoglycemia 6
- Can help to alleviate the physical, psychosocial, and financial burden associated with hypoglycemia, especially in individuals with type 1 diabetes 6
Indications for Glucagon Administration
Glucagon is indicated for the treatment of severe hypoglycemia, which can occur in individuals with diabetes who are taking insulin or other medications that can cause hypoglycemia. The following points highlight the indications for glucagon administration: