If you take insulin: you need a prescription for emergency glucagon

You’d be surprised…no one ever mentioned to me getting or needing glucagon. I only got it because so many people talked about having it. So I finally asked.

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You actually do not need a prescription. You can get it from Canada without a prescription. Mark’s Marine Pharmacy will ship it to the U.S.

I have purchased thousands of dollars on glucagon over the years and never once used it. The old kits required mixing and bringing a solution to a reconstituted state.

So much easier to just eat sugar. The only reason you would need it is if your were totally in shock and not responsive.
Then you would need to expect someone else to administer it.

I stopped buying glucagon about 10 years ago.

I don’t think just sugar would always work. It’s just not as fast. I know a couple of people that have had to use it. One ended up using 2, she started suddenly dropping dramatically and lives alone, she did not want to pass out or if she did at least be assured she would wake up. Especially since sugar has to go through some digestive process and would take longer to hit. I’m not sure you could try to dissolve enough sugar in your mouth to try to get it to work faster. You have the exercise type gels that work pretty quick. Although still would require some digestion.

And of course there is Baqsimi now, which is much easier.

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I have to disagree. Because the injections are subcutaneous and that requires some time to hit your blood stream.

If I drink juice or eat some glucose tabs, I feel better pretty fast.

That being said, if you are running low for a long time like as in over night, your liver may have already depleted it’s glycogen stores. In which case glucagon will not help since your liver is already depleted,

Again, I have never had to use it so I have no experience. I only know from my own lows where I have an intense desire to eat and I do and I feel better.

I had one instance where I was sleeping and could not wake up and ambulance was called, they didn’t give me glucagon, they injected dextrose and I came around.

There are also side effects from glucagon none of which are attractive to me.

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if you need it you can’t do it yourself. So, too bad for us who live alone. Just use a cgm and catch the drop before you need glucagon. When delirious you’re not opening the orange box to reconstitute and draw up the solution to do IM inj. So I would forget it for most individuals. Paramedics rightly have it in the tackle box. But ordinary individuals don’t need to pay $$$ to waste on this.

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I keep Baqsimi on hand and have used it once. This is a nasal spray.
But prior to that had syringe based glucagon, always expired and never used them.

I wonder if paramedics are using Baqsimi now?

My endo rx 2 for me right away after I got out of hospital and now I have the nasal spray. It is better to get iv sugar though so people have told me if you are in a true emergency, faster and no side nasty effects. Except maybe a spike. I remember they gave me that when I was in the emergency room in DKA and my bg dropped to 40’s- a huge syringe of glucose which the nurse said was the magic bullet. Bg went to 250 fast and kept jumping all over.

In DKA it is better to lower bg slowly and normalize with fluids and smaller amounts of insulin, otherwise bg jumps all over and dka takes longer to resolve. Keeping bg higher for a while and lower it slowly.

No, they use iv glucose which is much better. A friend told me she gets that frequently when they come to her home, she has very bad lows.

You definitely could do the nasal spray yourself very easily if conscious and you could do the injection too. The nasal spray is good because anybody can easily do that for you if you’re unconscious.

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It is a medical fact Lows or very bad lows can cause a form of dementia who would want that on top of everything else.

I’m certain that there are some people who are insulin dependent who have had instances where an emergency glucagon kit saved their lives.

Glucagon is a first aid tool. You are either in a situation where it is needed or not. Not all people who use insulin are in a situation where they are at high risk of hypoglycemia and have no other means of countering it. If they were experiencing severe hypoglycemia, a prescription for glucagon would be as useful as a doctor’s appointment the next day.

In 45 years of insulin dependence I’ve never needed glucagon which is why I would not suggest that a glucagon kit was a necessity for everyone who uses insulin.

If you are able to use one on yourself, you could use quick carbs with the same effect. It’s a last resort because it’s placing your life in someone else’s hands and requires another person be present.

But I’ve been fortunate to have had advantages that others don’t. I’m a very careful person who has traits, habits and conditions where I can use them. I’m not an expert, but I’ve spent a lot of time thinking about how my behavior affects my risks of hypoglycemia, and come up with a list of the things I believe are relevant. .

If you go through the list below and total the ones that don’t apply to you, the higher the count the more likely you are to ever need glucagon. If your count is more than 3, consider keeping an emergency glucagon kit with you. Regardless, always keep quick carbs with you 24x7. (A tab in time saves an ambulance’s whine.)

  • I am adult male.
  • I have a moderate exercise/activity routine.
  • I use only one type of insulin.
  • I prepare most of the food I eat
  • I always measure or know the content of what I eat.
  • I live with another adult who understands how I manage my diabetes and can detect if I’m “off”, starting to get sick
  • I wear a CGM, or I always test my blood glucose before every bolus, and bedtime and more often when I’m sick.
  • I keep accurate timely records of my insulin doses and meals.
  • I see a PCP and/or endocrinologist at least 3 times a year, plus whenever I feel sick.
  • I wear an insulin pump and I have a very high time in range, or I inject insulin MDI and my A1C is below 7.
  • I have no seasonal or other physical or psychological (SAD, bipolar, etc) health cycles.

Add 3 points for each of these :

  • I’m very careful about my insulin doses and I am not distracted when I take them.
  • I have no heart or other health conditions and take no medications that might impair my judgement, coordination or consciousness.
  • I have full mobility and can care for myself without assistance.
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I am not sure why you are addressing me here?

You do need a prescription. Once a pharmacist just gave me one, because I really needed it. In the perhaps 3 times it was used on me by family members or people that were around me at the time, maybe once it was able to be used properly and did work. The other two times it was difficult to do for the people. Body jerking, muscle reactions, couldnt do it. There have been times with severe lows that i wake up with people holding me down. Anyways, yeah people that live alone it probably wont be great, but it does work, no matter the time, the result is it does work. I dont like lows though, because i never feel like i ate enough and sometimes eat too much. You got to give the body time. I try to raise my sugars before i go to sleep, you should also check the averages between going to sleep and waking up the next morning. If your sugar drops say 100 points each night on average when you sleep, you should make sure that your number is in a good range before going to sleep. Going to sleep is my main fear with lows. And any lows that cause shaking and confusion are dangerous too. The time i needed it, my sugars were not going down i couldnt hold any food down, very likely dka, i had to take a little bit of extra fast acting insulin and so i was worried it would drop and i wouldnt be able to pick up the level if i wasnt holding down any food. But glucagon does work.

In a situation like this, sounds like basal testing is urgently needed.

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I’ve had type 1 for years at this point, and I definitely was told to have glucagon. Thankfully, I’ve never been in a situation where someone needed to use it. More accurately, the time I passed out I was alone, so my body did the work and I eventually woke up.

I was put on a CGM immediately. With a CGM, you’re less likely to have a severe low, but I keep BAQSIMI in my diabetes kit as “a just in case”. I mean why not increase my odds should something happen? I just hope that between my insulin pump and CGM nothing will happen.

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I had a bad low last year and became very nauseous after scarfing down not yet enough glucose tabs. I was also very lethargic and just couldn’t move. Thankfully I was alert enough to ask my husband to get the Gvoke syringe and give me a microdose. I responded quickly (in about 15 minutes) and topped out about 190, which I was quite happy with, all things considered. :pray:

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As with everything relating to diabetes, each person has a different treatment plan and different life situations.
My parents had and used a few times when I was a young child and was in the urine testing timeline. It did indeed save my life! And of course throwing up afterwards was not fun but I was alive.
When I moved across the country with my than boyfriend now husband, I had one. It made sense to have it because there was someone living with me. If I was by myself, I might not have bothered but I had one for awhile. But once blood testing and the “intensive insulin” treatment became the norm, I stopped ordering it because I was testing so much!
Now with a system that turns off the insulin when running low, I have not gotten a new glucagon prescription in a long while.
But with some many of the new types out there, it might not be a bad idea. I love the inhaled idea because anyone can do that one for another person.
But this is just a very personal choice. I mean, what I have in my emergency diabetes kit is not what the next person with diabetes will have.
So I think just do you! Whatever works for you is the best way to go!

I’m surprised how many people are anti glucagon. Nobody plans for an emergency. It’s all those crazy factors we don’t expect that we need to be prepared for. I do consider it a tool for someone else to use on me if I go into seizures, though. So I really don’t see much point for someone living alone, unless they think they’d actually use it while still conscious.

It’s honestly not even a choice for me anymore, as my husband insists on it. I’ve only seized twice in the last 20 years. The first one he saw was on our first ski vacation at 14,000 ft, and before I knew how badly drastic altitude changes affected me. We hadn’t even hit the slopes yet. I started seizing in the middle of the night after driving all day, and scared the life out of him. He managed to pour enough juice in/on me that eventually I stopped, but glucagon became a justified demand after that. He never wants to feel that helpless again, no matter the cost.

Granted that was before I had CGM, but even now, the unexpected is still out there. He used one of the kits for the first (and only) time on me last year, when I was in fairly excellent control and had the CGM to warn of the impending low. I just had the flu, and a terrible fever that burned up all my blood sugar. I was having a hard time keeping enough juice down to counteract the fever. I couldn’t handle it on my own and eventually started convulsing. I wasn’t sick enough or dehydrated enough to feel like I needed to go to the hospital. I wasn’t laying on my deathbed or anything. It was just standard flu… until it wasn’t. We had been over how to administer it a dozen times, so he knew how to mix it, to sit on me to still my thighs, and quickly and deliberately deliver the dose without remorse or hesitation. Within minutes the incident was done and I was alert again.

I can’t imagine the time it takes to call emergency services, convince the operator to dispatch an ambulance, wait for it to arrive, the medics to do their own evaluation for liability, decide on a course of action, get an IV set up, and the IV dextrose actually taking effect… could possibly work any faster than that quick glucagon shot. And the cost of an ambulance is surely higher than the glucagon, too!

We have an agreement. So long as I’m above 55, he’ll leave me alone to deal, unless I ask him to fetch sugar. (Probably happily, since I’m mean when hypo.). But when the critical alarms go off, he wants to be at the ready to act if it becomes necessary. It doesn’t matter how many times I’ve been fully conscious and coherent while hypo. The exceedingly rare bad incidents have planted that seed of fear.

Edit: I looked it up. According to the NIH in the US, “Emergency medical service units average 7 minutes from the time of a 911 call to arrival on scene. That median time increases to more than 14 minutes in rural settings, with nearly 1 of 10 encounters waiting almost a half hour for the arrival of EMS personnel.”

And that’s before any treatment is even given.

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