Glucagon Essentials: How to Use & Store Your Life-Saving Injections!

In the realm of diabetes management, insulin often takes the spotlight, but there's another crucial player that deserves our attention: glucagon. This hormone plays a vital role in regulating blood sugar levels, especially in case of severe hypoglycemia, a potentially life-threatening situation.
 
Understanding how to properly use and store your glucagon injections can be a lifeline in such emergencies. So, let’s get to it!
 
Related article: Does Insulin Need to Be Refrigerated? How to Store Your Pens & Vials Correctly?

If reading is not your thing, we have an alternative for you! Check out our video on the same topic, presented in a different format.

What is Glucagon?

Glucagon is a hormone produced by the pancreas, more specifically, by the alpha cells of the islets of Langerhans in the pancreas.
 
Its primary role is to stabilize blood sugar levels by promoting the conversion of stored glucose (glycogen) in the liver into glucose to be released into the bloodstream. This process is known as glycogenolysis. Glucagon also helps stimulate gluconeogenesis, the production of glucose from non-carbohydrate sources, such as amino acids and fats.
 
Glucagon acts in opposition to insulin. While insulin is released in response to high blood sugar levels and works to decrease it, glucagon is released when blood sugar levels are low and works to increase it. Together, these glucagon and insulin help regulate blood sugar levels.

Related article: Insulin Travel Cases, The Must-Have Companions for Diabetics!

Glucagon injections

In people with diabetes, Glucagon injections are used as an emergency treatment for severe hypoglycemia (low blood sugar). If someone with diabetes (especially type 1 diabetes) has injected too much insulin or hasn't eaten enough carbohydrates, blood sugar levels can become dangerously low.
 
Injecting synthesized glucagon tells the liver to quickly release stored glucose into the bloodstream so blood sugar levels can rise. In an emergency hypoglycemic episode, the person may be unconscious or unable to ingest sugar orally to raise their blood sugar. Therefore, an injection of glucagon can be necessary.

Glucagon emergency kit for low blood sugar

Glucagon for injection comes in a kit with a syringe containing a liquid (sterile water) and a vial of powdered glucagon.
 
It’s carried in a bright orange case, so it's easy for you or your caregiver to find it in an emergency. People with type 1 diabetes prone to severe hypoglycemia should always carry a glucagon emergency kit.
 
Once the glucagon is injected, the person should regain consciousness and be able to eat within 15 minutes.
 
However, after the immediate crisis has passed, it's important to contact a healthcare provider or go to the emergency room because severe hypoglycemia can be life-threatening. It's also recommended that anyone who might need to use a glucagon injection kit, such as family members or friends of a person with diabetes, should be trained in advance on how to use it.
 
Related article: A Step-by-Step Guide to Using Insulin Pens for Injections.

Other forms of glucagon

Other forms of glucagon for emergency treatment of severe hypoglycemia have been developed recently and don't require mixing, which may be more convenient to use.
 
The nasal powder glucagon, BAQSIMI, developed by Eli Lilly and Co., provides a different, needle-free approach to glucagon administration. It is delivered with a nasal spray.
 
Xeris Pharmaceuticals has introduced another innovative form of glucagon delivery—a pre-mixed, shelf-stable glucagon pen called Gvoke HypoPen. It's a prefilled autoinjector pen that does not require mixing the glucagon.  
 
Always consult your healthcare provider for personal medical advice about using emergency hypoglycemia treatments like glucagon.

How to Administer Glucagon?

Administering glucagon injections is a fairly straightforward process that can be done by anyone trained on how to use the glucagon kit. Detailed instructions for use are included in the carrying case.
 
Here's a step-by-step guide on how to inject glucagon in case of severe hypoglycemia:

• Check the person's condition: If someone shows signs of severe hypoglycemia, such as unconsciousness or seizures, and can't ingest glucose orally, glucagon should be administered.

• Prepare the Glucagon Injection Kit: Open the glucagon kit. You will find a vial of powdered glucagon and a syringe filled with a liquid solution.

• Mix the Glucagon: Take the syringe cap off and insert the needle into the powdered glucagon vial. Push the plunger down to inject all the liquid into the vial. Swirl the vial gently until the powder completely dissolves and the solution is clear. 

• Draw up the glucagon: With the needle still inside the vial, turn the vial upside down. Pull back on the plunger to draw the glucagon solution back into the syringe. Make sure you draw up the total amount of liquid.

• Administer the Glucagon: Insert the needle at a 90-degree angle into the person's skin at the chosen injection site. Press the plunger all the way down to inject the glucagon. 

• Aftercare: After administering the injection, turn the person onto their side. People with low blood sugar are likely to vomit, so this helps prevent choking. 

• Call for medical help: Call for immediate medical help after administering glucagon.

• Monitor the person's condition: The person should regain consciousness, and their blood sugar levels should rise within 10 to 15 minutes of administering the glucagon. If they don't, or if they continue to have symptoms of severe hypoglycemia, seek immediate medical assistance.

Remember, glucagon is a treatment for severe hypoglycemia, a serious condition that needs to be treated quickly. However, glucagon is not a replacement for emergency medical care. Always call for medical help when severe hypoglycemia occurs.
 
Finally, everyone's situation is unique, so these steps might not apply to your situation.Always follow the instructions provided by your healthcare provider and in the glucagon kit.
 
Related article: 10 Tips That Work to Inject Insulin Without Pain!

Where to give glucagon injections?

Glucagon injections must be given subcutaneously (just under the skin). The best injection sites are areas with a decent amount of fatty tissue, which tends to absorb glucagon well. The most common sites are the upper arm, the thigh, and the buttock.

Related article: What are the Best Insulin Injection Sites?

How to Store Glucagon?

Glucagon kits should be stored in a cool, dry place until needed. Here are some specific instructions for storing glucagon:

• Control storage temperature: Store the glucagon kit at room temperature, ideally between 68°F to 77°F (20°C to 25°C). It's important to avoid extreme temperatures. Do not freeze the glucagon kit, and avoid leaving it in a hot car or other places where it might be exposed to high heat.

• Keep in original packaging: Keep the glucagon in its original packaging until you're ready to use it. This will help protect it from light and moisture.

• Check expiration date: Pay attention to the expiration date on the glucagon kit. Expired glucagon may not work as well, so be sure to replace your glucagon kit before it reaches its expiration date.

• Do not keep after mixing: If you have a glucagon kit that requires mixing, once the glucagon powder has been mixed with the liquid, it should be used immediately and cannot be stored for future use. Do not pre-mix glucagon ahead of time.

• Dispose of it safely: Dispose of any unused or expired glucagon kits safely. Your healthcare provider or local pharmacy can guide you on properly disposing of these kits in sharps containers.

• Keep it accessible at all times: Store the glucagon kit in a location that is easily accessible in case of an emergency. Always carry it with you. 

Remember, these guidelines may change based on the specific glucagon kit and device. Always refer to the storage instructions provided in the package insert or consult your healthcare provider or pharmacist.
 
Related article: The Ultimate Checklist for Traveling With Diabetes.

How to keep glucagon cool

As mentioned above, the glucagon emergency kit should be kept at room temperature between 68°F to 77°F (20°C to 25°C). Exposure to temperatures above that range may impair its efficacy.
 
Therefore, when living in or traveling to places where the outside temperature frequently gets above 77°F (25°C), you should protect your Glucagon injections from the ambient heat.
 
During hot summer days, there are several measures you can take to protect your glucagon kit from excessive heat:

• Avoid direct sunlight: Never leave your glucagon kit in direct sunlight. Even on relatively mild days, the temperature in direct sunlight can be much higher than the ambient temperature.

• Do not leave it in the car: Avoid leaving your glucagon kit in the car, as temperatures inside a parked vehicle can quickly rise significantly, even if the car is parked in the shade.

• Use an insulated cooling bag: If you're carrying glucagon with you, consider using an insulated bag or cooler with a cool pack to help maintain a stable temperature.

• Indoor storage: When you don’t need to carry it, keep your glucagon kit indoors, in a cool, dry place out of direct sunlight. This could be a closet, drawer, or pantry. Avoid areas near heat sources, such as the kitchen or a bathroom, that get warm and steamy.

• Travel considerations: If you're traveling, carry your glucagon kit with you in your hand luggage rather than checking it in, as temperatures in the cargo hold of an airplane can become extremely cold or hot. 

4AllFamily’s Companion Cooling Bag is equipped with 3 layers of insulation and ensures your Glucagon Emergency Kit stays below 79°F (26°C) for 10 hours even when it’s 104°F (40°C) outside!

 
What about you? Have you ever used glucagon in an emergency? Your thoughts and experiences can enrich our discussion, so don't hesitate to comment below. Let's keep the conversation going!
 
Related article: The Parent’s Guide to a Safe and Happy Childhood with Diabetes.