Glucagon protocol

Type 1 and LADA
#1

So I'm filling out a volunteer staff health form for the camp I'm helping to run, and I hope I don't freak them out by the amount I'm writing!

This will sound ridiculous but I'm bringing a glucagon kit and realized that I don't know what the protocol is for if glucagon is used. I know if an epi-pen is used then 911 has to be called immediately to receive additional treatment and monitoring for the reaction. But I've never heard this in relation to glucagon ... so does 911 have to be called immediately? If not, how long do you wait to get medical help if there is no response?

#2

http://www.wakehealth.edu/Health-Encyclopedia/Health-Topics/Diabete... seems to recommend 911 at same time.

Personally I've always thought of as Glucagon as a last-chance there's no other way left to raise bg (e.g. unconscious or vomiting) emergency. So 911 right away if not before.


Glucagon is the "Davy Crockett" nuclear howitzer of blood-glucose-raising possibilities. Only after all other means of stopping the Russkis from coming across into West Germany are you to use it. (OK, I'm dating myself, keep falling back to cold war analogies).

A Glucagon kit, with its little stubby vial positioned at the end of the syringe, even LOOKS LIKE a little version of the M388 nuclear charge on the end of a Davy Crockett::





#3

I'm with you 100%, Tim. I'm not T1, so don't face this issue, and have no direct experience. I have plenty of experience with hypos, though, as a insulin using, tight controlling T2.

Seems to me that standard methods (i.e. shoveling carbs into the maw) should be used first, and glucagon only as you say, as a last resort. In which case it's very serious, and the paramedics should be called just in case.

#4

Haha, thanks. I agree, I put on the form to use it only if I can't be woken up, etc. The camp is a fair ways from any city so I think 911 at the same time as glucagon would be a good idea. Here's hoping I won't need either glucagon or epi-pen, but being in a strange place with strange food and a major change in activity level (without a CGM) always makes me a little nervous both diabetes- and allergy-wise.

#5

I have not had a severe low (where I've lost consciousness or needed help from others) in about 15 years. But I do experience hypoglycemia regularly, including some really low numbers like 1.6 and 1.8 (28 & 32) several times a year. Especially at a camp with major changes in food and activity level, I feel like my risk of a severe low or a severe allergic reaction is much higher than usual.

#6

I created my own personalized, illustrated guide, similar to the insert in the Glucagon kit. It lives on a laminated, two sided, color 8.5 x 11 sized information sheet attached to the Glucagon itself. It has nice pictures like on the insert, however they are much larger and I've included text too. I have it mounted at home in an obvious spot visible to visitors and rescue personnel. I'm also going to get one of the bright red Medic-Alert 'sleeves' to go on the strap of my bag, and put one in there too.

On it I have the following statement at the very top:

If patient is found disorientated, unconsciousness, or is suffering seizures or convulsions:
Call 911

Then...


Followed by instructions to suspend my pump, then how to mix and inject the Glucagon. I also have the 24 hour Medtronic phone number there, my Medic Alert ID & phone number, plus my emergency contact list. Just in case a responder needs help.

Then at the end, I have this statement:

Turn the patient on his side. When an unconscious person awakens he will most likely vomit. Transport to a hospital as soon as possible.

Oh and just because I'm slightly anal retentive, I've also got a Medic-Alert screen saver on my PC and on the lock screen of my phone. Oh and I've got my phone's "Safety Assistance" feature set up to take photos (front and back), record audio and send all of this to my emergency contacts along with my precise GPS location. Hopefully, I'll be able to manage three little clicks on on the phone's power button to activate.

Yes, I was a boy scout at one point in my life. :-)

#7

I've only used Glucagon once in almost 27 years. I've never passsed out but in this one case I had just taken injections of Lantus and Humalog before dinner and within a few minutes had double arrows down and was fading fast. We didn't call 911 because my husband was so busy trying to help me with the glucagon. I was awake and drinking coke but when I got to 27 with double arrows down and my vision going into like a tunnel and about to pass out, my husband gave the glucagon. What also scared me was how long it took my bg to come back up. It took almost 2 hours for it to get much above 100. I just remember being really cold after. My husband did make me call the on-call number for my endo's office though. Doc told me to eat extra protein and run higher for a few days.

Does anybody know how much the glucagon is supposed to raise you and how fast? Jen, I'm like you when I travel or go to a remote location environment. Better to prepare and not need any of it. I always run a temp basal to reduce basal for the first day long enough to see how I'm going to do with whatever the activities are.

#8

The one time I had glucagon, my wife called 911 and the EMT's gave it to me.

I have very very remote memory of them doing a fingerstick bg test on me and them talking to my wife. I was told the number was 42. I have been to 42 many times in the past and still been consciousl

I am told that I began coming around after just a few minutes after the glucagon. I think my bg had been way lower than 42 and it was starting to come up of its own accord.

I was actually in a daze for the whole day afterwards. And suffered super-nausea from the glucagon (I'm told a known, but not all that common, after-affect.)

I've also (many years ago) had glucose given to me by IV in the ER when my friends were able to get me there during a hypo and I wasn't keeping any food down. No super-nausea afterwards, but I still was in pretty bad shape for the next day or so.