Replies to This Discussion

Permalink Reply by Brent on June 26, 2010 at 10:51am

mm thats weird. In Australia all ambulances have to carry Glucagon now.. I think it has saved a couple of lifes

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Permalink Reply by Jennifer on January 20, 2010 at 4:50pm

It is critical if you have a low and are uncosncious and are away from prompt medical help. As you know, hypos can cause seizures from lack of glucpse to the brain (which can lead to death possibly). If you are unawake, or unable to consume glucose tabs or other hypo remedies, it can save your life if your family or friends can give it to you while awaiting medical aid. Your family should never give you anything orally if you are unconsciuos or unable to protect your airway. Glucagon is helpful and potentially lifesaving in these situations.

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Permalink Reply by Cheryl on June 27, 2010 at 7:20pm

We are on the third glucagon kit since David was diagnosed in 2003 and never actually used one yet, thank God.

We spend the $115 when one kit expires to buy a new one so that we do have it, in case of emergency. I have heard of a few incidents that might not have become what they became if a glucagon kit had been on hand, and David does carry his glucagon in his daily emergency kit.

Interesting to hear all of the feedback, low BG with alchohol considering we are parenting a T1 17 year old. He has told me that on more than one occassion that the endo has discussed drinking and that he should not bolus if he decides to have a drink as the after effect could be a devastating low. Maybe she should leap into these discussions when we are together, and not as part of the patient/endo only visit, as I had no idea that glucagon would be ineffective in this area as a low treatment. What else don't I know that might or might not save the life my soon to be independant teen.

Cheryl

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Permalink Reply by Brent on June 27, 2010 at 7:23pm

$115!!! Thats a outrage.. We are lucky to have our government in Australia to subsidize all our medications and diabetes supplies.. Ours costs around $30 AU which is much better then the $115 US

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Permalink Reply by Duchess on February 9, 2011 at 3:46pm

WHAT? You've never been incapacitated or gone to hospital? Are you sure you're diabetic???

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Permalink Reply by Carly on January 20, 2010 at 4:34pm

Last summer I spent all day concert where I was on strong antibiotics and out in the sun. I ended up vomiting all night, to the point where I couldn't even eat a glucose tab or drink juice without it...coming back up! I was of course dropping low so decided I didn't have much of a choice but to try glucagon. It's the only time I've taken it, and it worked like a charm, but I can't say whether it caused nausea since I was already in the thick of it =)

I've never heard about it being ineffective for a few days after you use it...so I guess it really needs to be a last resort!

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Permalink Reply by Jen on January 20, 2010 at 5:26pm

I have never used glucagon but have heard of it being used with regular insulin syringes in "mini doses" at times when either food can't be eaten (due to vimitting, unavailability, etc.) or when blood sugars aren't coming up on their own. Here's some information about it:

http://www.childrenwithdiabetes.com/d_0j_20w.htm

I've read that when used this way it doesn't have side effects (like vomitting, high BG later) to nearly the degree that using the full dose of glucagon at once does.

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Permalink Reply by Brian (bsc) on January 21, 2010 at 7:18am

This is an interesting use of glucagon. I am not aware of glucagon being part of any recommended insulin treatment regime for blood sugar control, but if you follow the literature on work for the full closed loop pancreas, you will see that it is being looked at as part of those systems. Small doses of glucagon are used to increase the rate of glucose produced by the liver, thereby enabling these systems to exert controls to both lower and raise blood sugar leading to much faster and stable control. Used for manual control the resulting blood sugar increase causes by the glucagon can be very unpredictable since the presence of insulin suppresses the response by the liver.

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Permalink Reply by Jen on January 21, 2010 at 8:11am

It's my understanding that high levels of insulin suppress the release of glucagon itself, which then stimulates the liver to break down glycogen into sugar. Once glucagon is in the system, though, I don't think high levels of insulin interfere with it (though alcohol or recent heavy exercise would), but maybe I am wrong.

In people without diabetes the body releases glucagon whenever it's needed. The problem is that for those of us with type 1 the release of glucagon in response to lows is highly blunted regardless of the amount of insulin present, and/or when glucagon is finally released it is too much, causing a rebound high. In the site above, the mini-dose glucagon would be used in order to avoid a trip to the hospital for treatment to prevent a severe low.

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Permalink Reply by Brian (bsc) on January 21, 2010 at 8:49am

Actually, I think "insulin suppresses hepatic gluconeogenesis," and this occurs in the liver. Google those terms. In an insulin dependent diabetic exogenous insulin can suppress the normal response of the liver to glucagon, thereby blunting the natural counterregulatory response. When blood sugar gets really low you get the stress hormones kicking in and then you get the bad hypos with the shaking, sweating and possible "lost cookies." I think there is real debate on whether glucagon production (which takes place in the alpha cells) and secretion is really dysfunctional in type 1s. I have seen a bunch of work indicating that alpha cells are mostly spared the attacks from autoimmune t1.

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Permalink Reply by Osob on January 21, 2010 at 9:36am

I have used it once at hospital even though I was awake and aware of everything happening around me the nurse was like you have to take it when all I wanted was something to eat or drink to bring it up.
I hate it with a passion.lol
But next time have some sort of drink or even jelly babies in your bag.

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Permalink Reply by Laura Soares on January 28, 2010 at 1:48am

We have a 4 year old daughter with Type 1. We are frequent users of "mini-dose glucagon" and are very experienced with it. Our doctor, Mary Simon MD in Fresno, CA, advocates using an insulin syringe and giving 1 unit of glucagon per year of life. We generally use 4-5 units, unless she is very low and stuporous. It is especially useful during the night and when she has a vomiting illness. She has random and fairly frequent lows at night. We check her 3-4 times a night. Tonight, she was 314 with 2 units of active insulin (per her pump). I re-checked her 2 hrs later, and she had dropped to 149 - still with 1 unit active. She is sound asleep. I gave her 5 units of glucagon, and rechecked in 1 hr. She is now at 257 (so i overcorrected a bit) with 0.5 units of active insulin. I will re check her in an hour.

We used glucagon last night too for a BS of 62. I have never had it not work, nor has she ever experienced any negative effects from these small doses.

The other day she was 36 and stuporous, unable to hold herself up, I gave her 20 units. she came right up to the mid-100s, ate, and went about her business.

Managing a diabetic preschooler is challenging at best due to erratic growth patterns and picky eating, glucagon is a very useful tool - not a last resort. In fact, mini-dose glucagon is widely used in Europe.

Laura - type ?, on a pump.
Mom to Natasha, type 1 on a pump
Registered Nurse

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