Treating mild and moderate hypoglycemia
When your blood glucose is too low, it is important to raise it quickly. This can be done with a quick source of sugar like:
- Apple or orange juice
- Dextrose tablets
- Jam, syrup
- Sugar cubes or honey
- Candy (although chocolate works slower)
- Sweet drinks like cola or lemonade—but not diet drinks!
After consuming one of these quick sources of glucose, it is a good idea to eat a slower source of glucose like a biscuit or piece of bread so you get a longer lasting source of sugar.
You should also stop any physical activities at once, and tell someone what is happening!
When you start to feel better have a snack or meal to make sure your blood glucose does not start to fall again.
Call your doctor/nurse or emergency service.
When the patient wakes up, give them something to drink like juice and soft drinks to raise their blood sugar level and to avoid a relapse of severe hypoglycemia.
A few useful tips
- Manage your diet and insulin to keep your blood glucose in your target range.
- Monitor your blood glucose frequently.
- In general it is always a good idea to avoid alcohol.
- Avoid skipping meals.
- Always carry along a source of “quick sugar” like dextrose tables or juice.
- Carry identification saying you have diabetes.
- Tell friends, relatives, teachers, co-workers and others you trust about diabetes and the risk of hypos as well as what they can do to help.
- Have a glucagon kit available, and make sure to check the date of expiration at least once a year—for example every New Year.
- Ask your doctor or nurse educator to train family or close friends on how to give glucagon in cases of medical emergencies.
- Make sure that people know that giving glucagon is safe: they can not hurt anyone by injecting it.
- Do not swim or drive long distances alone when your blood glucose may be low like before meals.
- If you have had a hypo, tell your doctor or nurse.
- If you can not feel hypo symptoms, please talk to your doctor or nurse about what action you should take. You may also want to ask your spouse if they are aware of you having a hypo you are not aware of yourself. A checklist is provided in the appendix for your convenience.
- If you do not know why your hypo occurred, talk to your doctor or nurse about adjusting your dose.
Frequently Asked Questions About Glucagon
Q: What is glucagon?
A: Glucagon is a biosynthetic human glucagon produced by Novo Nordisk. It is identical to the natural glucagon produced in the human pancreas.
Q: What is glucagon used for?
A: Glucagon is used to treat severe hypoglycemia (low blood sugar) reactions in non-hospital settings or when medical help is unavailable.
Q: Can patient families/friends and co-workers use the glucagon emergency kit?
A: Yes. The kit contains easy to follow instructions, so even someone without medical training can administer a glucagon injection. However training and practice can help prepare individuals to do it correctly without panicking in a real situation. Your doctor, nurse or diabetes educator will be happy to teach family, friends, teachers or co-workers how to properly administer the glucagon injection.
Q: What should my family/friends/co-workers and I discuss with my doctor/nurse about glucagon?
A: As glucagon kit is used for severe hypoglycemic emergencies in non-hospital settings as a life-saving drug. If you have a diabetic child, teenager, young adult or spouse, you may know that blood sugar can be hard to regulate. The glucagon emergency kit will enable you to administer emergency medical assistance so they can recover quickly from a hypo.
If you have diabetes, and have problems regulating your blood sugar, are under intensive insulin therapy alone or in combination with oral drugs, you should be aware that you are at risk for having frequent hypoglycemic episodes.
If you are a patient with diabetes that has a low sensitivity to hypoglycemic symptoms or has problems feeling them at all, you will want to contact your doctor or nurse for advice. The more often you experience hypoglycemia, the more “unaware” you may become, which will result in more episodes.
For most people with diabetes, it is better to being safe with a glucagon emergency kit than being sorry without one. Ask for training.
Q: What should I discuss with my family, friends, teachers or co-workers?
A: It is important that you are open about your diabetes and the risk for severe hypoglycemic episodes. Although diabetes management has improved dramatically, hypoglycemic episodes still happen. You and your family/close friends should be prepared to deal with them. For your own safety and the reassurance of those around you, please let your family/friends/co-workers know that you are a diabetic and at risk for hypoglycemia. Let them read through this booklet. Ask your doctor or nurse to train them to give you glucagon in case of an emergency.
Q: What dosages of glucagon should be used and is there a risk of over-dosing?
A: Dosage for adults is 1 mg and 0.5mg for children under 25kg. There is no danger of over-dosing.
Q: What is a glucagon emergency kit?
A: The glucagon emergency kit contains everything necessary for giving a lifesaving glucagon injection in the event of a severe hypoglycemic emergency.
Q: How is glucagon administrated?
A: Glucagon is injected into muscle, fat or in the vein. Injection may be repeated if necessary. It should be used immediately after mixing. Discard any unused product. After use, please have your glucagon emergency kit renewed.
Q: How effective is glucagon?
A: In case of severe hypoglycemia, a glucagon injection quickly raises the blood glucose to restore consciousness within 10-15 minutes. After the person has responded to treatment, give him or her an oral carbohydrate like juice or a soft drink to restore glucose levels and prevent relapse of hypoglycemia.
Q: Does glucagon have any side effects?
A: Severe side effects are very rare, although nausea and vomiting may occur occasionally especially with doses above 1 mg or with rapid injection (less than 1 minute). You may also have rapid heart beat for a short while. If you have any other reactions that you think have been caused by glucagon, please contact your doctor, nurse or local pharmacy.
Q: How should I store glucagon?
A: The storage condition can vary from country to country, so please consult the enclosed leaflet. In most countries it can be stored for 3 years, if kept between 2°C and 8°C. The glucagon kit can be stored at room temperature (up to 25°C) for 18 months provided the expiry date has not exceeded.
Do not freeze. The glucagon vial should be protected from light. Discard any not used product after injection. Do not store for later use.
Q: Can I use glucagon emergency after the expiration date?
A: Never use glucagon after the expiration date printed on the box. As glucagon is only used in severe hypoglycemic emergencies it is very important, that you always keep track on the expiry date, so you will have an updated kit available if the unexpected event of a severe hypoglycemia should arise.