As someone with diabetes, you may know what it’s like to experience severe hypoglycemia, also called low blood sugar. It is scary. A variety of diabetes medicines, such as insulin and the oral Type 2 drugs known as sulfonylureas, can cause lows.
Before I began researching diabetes, I had never heard of glucagon, the life-saving injection that many parents of children with Type 1 diabetes keep on hand. I wondered why my doctor never mentioned the use of glucagon to me. From what I discovered later, it could have prevented my trip to the emergency room when I came dangerously close to diabetic coma.
With diabetes, we are trying to regulate blood sugar artificially because our pancreas is not doing its job naturally. The process of blood sugar control is a complicated and delicate balance, and we can easily get it wrong. Overmedicating can lead to blood sugar bottoming out, which may end in the dreaded diabetic coma.
But there are many other reasons for severe hypoglycemia, things like strenuous exercise, alcohol consumption, drug interactions, and illness. So it is important to have a glucagon kit around just in case.
So why is it that many of us have never heard of glucagon? As I dug deeper into professional articles I began seeing the words “underappreciated” and “underused” in regard to glucagon. I read that in some states, school nurses are prohibited from training non-nurse school personnel to administer glucagon. The only people who are likely to have a glucagon kit on hand are probably parents of children with Type 1 diabetes.
Why is glucagon underappreciated and underused?
One reason may be that a glucagon kit must be used by a “trained” parent or caregiver. Glucagon comes in a powder that is mixed with sterile water right before it is injected. There is no stable liquid injectable available right now, so it has to remain in powder form. Even the powder can become useless if it is stored too long.
One study intended to evaluate the glucagon injection technique of parents of children with diabetes noted that 69% had difficulties “ranging from opening the container to drawing the correct dose into the syringe.” These parents had been shown how to use the kit but never actually used one before the study.
In an emergency situation it is obviously going to be hard to follow written directions and have the confidence to use the kit properly. Many times people have given up, opting to simply wait for professionals to show up.
But there is something new on the horizon. Web Editor Diane Fennell alerted her readers last year to open trials for a new nasal glucagon. Those trials have been completed, and the results sound phenomenal. This new treatment by Locemia Solutions ULC, called AMG504-1, is a powdered glucagon that is released into the nose through a one-time-use dosing device. It is not inhaled but enters the bloodstream through the nasal tissue.
It was tried on children with their parents’ consent, and it worked as well as a conventional glucagon kit.
If and when this new nasal glucagon becomes available, it may revolutionize prevention of the dreaded diabetic coma. Because we are encouraged to get tighter and tighter control of blood sugars, the danger of low blood sugar has grown. My experience with it is echoed by blogs and research studies all over the Internet.
Having glucagon at hand in such a usable form will ease the minds of the parents of Type 1 children who deal may with low blood sugars several times a week. It might mean fewer emergency room visits for people with Type 2 who might never have heard of glucagon before.
It looks like the product may be on the market in 2016 or 2017. I look forward to seeing it change the face of severe hypoglycemia for both Type 1 and Type 2 diabetes.
Are sugary drinks really as bad as they’re made out to be? Bookmark DiabetesSelfManagement.com and tune in tomorrow to get the scoop from nurse David Spero.