What is Glucagon and How Does it Work?

Glucagon is a counter-regulatory hormone secreted by the pancreas when blood sugars are dipping or during periods of emotional or physical stress. This hormone liberates stored glycogen from the liver, causing an upward surge in circulating glucose.

When people become hypoglycemic, there is not enough circulating glucagon available to drive more glucose release. Glucagon rescue medications increase glucagon levels enough to stimulate further glucose release from glycogen stores in the body.

While administering glucagon is life-saving, it also depletes the body of its glycogen reserves and can lead to further hypoglycemia if it is not replaced quickly. It is so important to replace glycogen stores by consuming carbohydrates as soon as it is safe.

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3 Different Glucagon Rescue Options

When someone with diabetes is experiencing severe hypoglycemia and needs the assistance of another person, there are now 3 Glucagon options to choose from.

Here are some highlights of the currently available Glucagon Rescue Medications. Below, is our new Glucagon PocketCard that helps to compare and contrast the delivery system, dosing, age range, route, and storage all in one card.

Nasal Glucagon – Baqsimi (Back-see-me)

Baqsimi is a nasal glucagon powder to treat severe hypoglycemia in people with diabetes ages four and older. This non-injectable form of glucagon is available as one pack or 2 pack.

It is approved for pediatrics over the age of four with type 1 diabetes and adults.

Baqsimi does not need to be inhaled, which means it can be effectively administered to a person who is unconscious due to severe hypoglycemia.

*Eligible commercially insured people with diabetes can pay $25 for up to two BAQSIMI devices (1 two-pack or 2 one-packs) with a savings card. This prescription is generally filled on an annual basis. For more info visit www.BAQSIMI.com or call The Lilly Answers Center at 1-800-LillyRx (1-800-545-5979).

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Gvoke Pre-Filled Pen or HypoPen Auto-Injector

Xeris Pharmaceuticals offers a pre-filled liquid stable form of glucagon that is approved for use in people with diabetes, ages 2 and older. They also have an HypoPen Auto-Injector.

The Xeris glucagon pen was created to simplify glucagon injections. This new Gvoke pen does not require any mixing since it is filled with liquid stable glucagon.

Gvoke Pre-Filled Syringe and HypoPen 2-Pack^TM is also available. Health care professionals can request a Gvoke HypoPen demo device by completing this request form or contacting your local sales representative. Read more about the Gvoke Glucagon Pen and auto-injector here.

Eligible commercially insured people with diabetes can pay as little at $0 by completing the Gvoke Copay Card* form. Visit this page to sign-up.

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Glucagon Emergency Kit | Powder + diluent

Both Lilly and NovoNordisk manufacture this injectable glucagon that requires mixing glucagon powder in a vial with a diluent, then injecting either sub-q or IM. It can be administered to all ages, but give a half dose for children weighing less than 45kg.

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Emergency Action Steps

Glucagon rescue medications raise blood sugar by at least 20 mg/dl and should start working within 15 minutes.

• After administration, make sure to seek medical help and roll person on their side since glucagon can cause nausea and vomiting.
• If no response after 15 minutes, administer a second dose.
• After the person gains consciousness and can safely swallow, administer food or beverage containing at 15 -30 gms of carbohydrate until blood sugars are back in a safe range. Then follow-up with the usual meal.
  
  15 gms of carbohydrate ideas:
  • 4-8 ounces of juice or sugary beverage;
  • A piece of fruit, a handful of raisins, tablespoons of honey or corn syrup;
  • 4 glucose tabs, glucose gel, or GU energy gel.

Glucagon PocketCard

When addressing severe hypoglycemia, fast and effective treatment is critical. Diabetes Specialists have a vital role in making sure those at risk of a hypoglycemic crisis have a glucagon rescue medication available.

Our new PocketCard provides a concise review of the 3 Glucagon Emergency treatment options.

This card can serve as a decision tool when discussing the pros and cons of the currently available rescue medications with providers and people living with diabetes.

Our new Glucagon PocketCard compares and contrasts the delivery system, dosing, age range, route, and storage of the currently available rescue meds all in one card.

View it for FREE anytime our CDCES Coach App by clicking on the PocketCard Image on the home screen.

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Download it FREE on our PocketCard Page.

Glucagon Rescue Medications require a prescription. Check expiration dates before using them. This information on the Glucagon PocketCard is for educational purposes only. Please consult package inserts for detailed instructions.

Teaching Resources

Hypoglycemia and Hyperglycemia Education Teaching Sheet » This handout is one of my favorites. Cartoon characters depict the signs and symptoms of low and high blood sugars and then detail steps to take.  

Medication Wallet Card PDF » pocket-sized document that includes contact info, list of medications, and critical health data.

Medication Wallet Card in WORD » Add your program’s logo and provide your clients with a useful, customized document that includes contact info, list of medications and critical health data.  

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