Diabetes is a balancing act, especially when you take insulin or oral medications that lower blood glucose (blood sugar), especially sulfonylureas. If you do unplanned activity, skip a meal, or give yourself too much insulin, your blood glucose levels can dip and you quickly can develop low blood glucose.

Low blood glucose, also known as hypoglycemia, can cause you to have poor judgment or even lose consciousness. When you have severe hypoglycemia, it means you can’t swallow glucose-containing foods or drinks on your own to bring your levels back up.

When this happens, you’ll need to turn to glucagon.

Glucagon

Glucagon—a hormone that raises blood glucose levels—is used to treat severe hypoglycemia. Glucagon is taken as a spray into the nose or an injection administered under the skin.  

If you use insulin or a sulfonylurea to manage your diabetes, it’s a good idea to keep a glucagon kit with you in case of emergencies. You should also stash a second kit at work or in your car for extra security. Make sure your family, friends, and coworkers know how to use it in case of emergency. 

Check that you have an active prescription for glucagon. Before buying glucagon, check the expiration date—it should have at least a year of shelf life remaining.

Researchers have worked hard to bring us a future where glucagon delivery isn’t a multistep process. They have developed glucagon products that require no mixing or injection. Their goal? A fast hypoglycemia treatment that lessens a caregiver’s stress during a tense emergency situation—and saves lives.

Glucagon products now available in the U.S. and Food and Drug Administration (FDA)-approved:

Nasal Powder

Eli Lilly and Co.’s powder glucagon uses a device similar in size to a typical nasal spray to drive powdered glucagon into your nose, where it’s absorbed into the bloodstream.

This is a fast, one-step process. Because it’s needle-free, it may be less scary for caregivers and easier to deliver correctly. Like current treatments, nasal glucagon can be given to an unconscious person. 

Pre-Mixed, Shelf-Stable Pen

Xeris Pharmaceuticals’ device works similarly to EpiPens and other pens prefilled with medicines, such as insulin and type 2 injectable drugs. The device will contain a stable form of glucagon that’s already dissolved into liquid.

Because the glucagon is premixed, the caregiver simply removes the cap and injects it into the person with severe hypoglycemia. The pen pushes glucagon into the system as quickly as a glucagon kit.

How to administer mixed glucagon

A caregiver needs to:

1. Remove the seal from the vial of powder and the needle cover from the syringe.
2. Insert the needle into the vial and push the plunger to empty the saline into the powder.
3. Gently roll or swirl the vial to dissolve the powder into the liquid until it is clear.
4. Draw the solution back into the syringe.
5. Inject into the outer mid-thigh or arm muscle of the person with severe hypoglycemia.
6. Turn the person on his or her side in case of vomiting, a common side effect.

But remember, these are general rules, and you should always follow the manufacturer’s instructions for how to safely administer their glucagon. If you have further questions, be sure to contact your doctor.