Chapter 11: Glucagon and Mini-Dose Glucagon

Glucagon and Mini-Dose Glucagon

Glucagon

Food or drink should not be given to a person with low blood glucose if there is a chance he or she might choke. Glucagon is a hormone the body makes that allows sugar that is stored in the body to be released. Glucagon comes in an emergency kit that has liquid in a syringe and powder in a vial.
 
Give glucagon by injection if the person with low blood glucose:
  • Cannot swallow
  • Is unconscious
  • Is seizing (uncontrollable jerking movements)

How to give glucagon by injection:

Picture 1

  1. Remove the cap from the vial with the glucagon powder.
  2. Remove the cap from the needle on the syringe.
  3. Inject all of liquid in the syringe into the vial with the powder (Picture 1).
  4. Keep the syringe in the vial while you roll or swirl the vial gently. Do this until the solution is clear.
  5. If your child is older than 5 years and weighs more than 45 pounds, draw up all of medicine into the syringe. If your child is younger than 5 years or weighs less than 45 pounds, draw up the medicine to the 0.5 mg mark on syringe (Picture 2).
  6. Inject the medicine under the skin or into the muscle where you would give an insulin injection (See Chapter 6, Insulin Injections, page 28).
  7. Turn the person on their side. Throwing up (vomiting) may happen after glucagon is given.
  8. Call 911 (Picture 3).

 

Picture 2

Picture 3

 

Glucagon is a safe medicine to give. If in doubt, give it.

After giving glucagon:

  • Check blood glucose every 15 minutes.
  • When the person is awake and can take food or drink, give 15 grams of carbohydrate.
  • When you can, call the endocrinology office or doctor on call. Insulin doses often need to be changed.
Tips
 
  • Glucagon can be stored at room temperature. Avoid very hot or very cold temperatures when storing.
  • It is a good idea to keep glucagon at home and at school.

Mini-Dose Glucagon

If a person has signs of mild to moderate low blood glucose and cannot eat or is vomiting, a small dose of glucagon may be given to raise the blood glucose. This is called mini-dose glucagon.
 
Mini-dose glucagon will usually raise blood glucose 50 to 100 mg/dl (points) in 30 minutes without causing nausea.

How to give mini-dose glucagon:

1. Open the glucagon emergency kit.
2. Mix the liquid with powder as instructed on the lid of the kit.
3. Draw up the glucagon from the vial with an insulin syringe. Measure the correct dose for the person’s age in units using the chart below.

Mini-Dose Glucagon
0 to 2 years old 2 units
3 to 15 years old

1 unit for every year

Example:

3 years old = give 3 units
4 years old = give 4 units

16 years and older  15 units
 
4. Inject the mini-dose of glucagon the same way you would inject insulin (See Chapter 6, Insulin Injections).
5. Store the leftover glucagon in the refrigerator.
6. Check the blood glucose every 15 minutes. If the blood glucose has not started to rise at 15 minutes or is not above 80 mg/dl at 30 minutes, repeat the mini-dose. Make sure this second dose is double the amount of mini-dose glucagon you gave the first time.
7. Give the same amount of mini-dose glucagon injection you gave the first time, every hour as needed, to keep the blood glucose above 80 mg/dl.
8. The glucagon vial can be used for 24 hours after mixing if it is kept in the refrigerator.
9. Throw the mixed glucagon vial away after 24 hours.
 

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