Understanding Emergency Glucagon

If you have advanced type 2 diabetes, your diabetes management likely includes taking daily injections of insulin. If this sounds like you, please take a moment to read the following article about glucagon.

Many of you are probably well aware that hypoglycemia (low blood sugar) is the most common and potentially serious side effect of insulin therapy. In fact, you may have already experienced a mild/moderate low blood sugar that was successfully treated with juice or glucose tablets.

But, what happens if you ignore the initials symptoms of a low blood sugar, or if you have hypoglycemia unawareness (a low blood sugar that occurs without symptoms)? Both scenarios may result in a severe low blood sugar.

When is a low blood sugar consider a SEVERE low blood sugar?

There is no single universal blood glucose number for what defines a severe low blood sugar, but rather, as outlined by American Diabetes Association and The Endocrine Society, a severe low blood sugar:

  • “Requires assistance of another person to actively administer carbohydrates, glucagon, or take other corrective actions”
    • During a severe low blood sugar, the individual may be unconscious or having a seizure
    • “Plasma glucose concentrations may not be available during an event"
  • “Neurological recovery, following plasma glucose levels returning to normal, is considered sufficient evidence that the event was induced by low plasma glucose concentration”

Risks for having a severe low blood sugar

How is a severe low blood sugar treated?

  • Intravenous (IV) dextrose. IV dextrose can only be administered by a qualified health care professional.


  • Intramuscular or subcutaneous injection of Glucagon. A glucagon injection can be given in a non-medical environment by a trained parent/caregiver.

What is Glucagon?

  • Glucagon is a hormone made by the alpha cells in the pancreas
  • It is the main counter-regulatory hormone to insulin
  • When given as an injection, glucagon tells the liver to release stored glucose (glycogen) in an effort to rapidly raise blood glucose levels.

Who makes emergency glucagon?

What does a glucagon kit look like?

  • An emergency glucagon kit comes in a brightly colored container (usually orange or red)
  • The kit contains a vial of glucagon powder and a prefilled syringe with solvent
  • The kit includes text and graphic instructions for reconstitution and use
  • A glucagon kit should be stored at room temperature until its expiration date

A few final thoughts:

  • If you manage your diabetes with insulin, talk with your physician about an emergency glucagon prescription.
  • Someone close to you (spouse, caregiver, friend, etc.) will need to be trained in the proper use of emergency glucagon.
  • Training can be done by a health care professional (such as a nurse or diabetes educator) or there are many useful training tools provided by Eli Lilly and Company as well as Novo Nordisk. Training should be repeated (at minimum) annually.

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