Okay, I have absolutely no intention of doing this! However, discussing hypos in another thread, and dealing with them quickly, got me thinking about this question.
I mean, what better way to raise BG quickly than to inject glucose directly into a vein? Even subcutaneous, it would absorb fairly fast and get the BG going up, bypassing all that time spent working through digestion.
So, there's gotta be a reason T1 emergency kits have glycogen instead of simply some well-calibrated dosing of glucose directly. But I can't imagine what it is.
Ringers Lactate, among the most common replacement fluids after blood loss, contains lactate, which is turned into glucose by the liver. While not exactly direct glucose into the bloodstream, it's not far from it.
I'm pretty sure I read somewhere that pure glucose kills cells if it's not injected directly into the bloodstream. I don't know about you, but during a low opening a tube of glucose tablets is hard enough—I do not want to be trying to inject glucose into a vein!
However, there is such a thing as mini-dose glucagon. Basically you mix the glucagon up and then draw it up with a regular syringe. Not sure how long glucagon lasts once it's actually mixed up, though.
I personally don't mind treating lows with sugar. I don't think an injected substance would be much quicker, unless it was injected directly into the bloodstream, which I already covered above.
However, what I would REALLY like is a glucagon auto-injector, similar to epinephrine auto-injectors they have for severe allergic reactions (EpiPen, etc.). This would be easy enough to use even during a pretty severe low, and easy enough to use that anyone could be trained to use it or could use it just based on simple instructions printed on the side. I don't carry a glucagon kit right now because I live alone, take public transit to work, and I think it's asking people at work too much to mix up and inject glucagon (but they all know about my EpiPen because EpiPen is standard first aid training).
I just read in an insulin nation email update that researchers are currently working on and testing a glucagon that stays stable at room temperature for the artificial pancreas and which could be used in pens etc. I hope they will have it soon- I would like this also. I also agree injecting into a vein is something you need to be properly trained to do and not something to try to do if you're severely hypo- lol. Btw, Dave, it's my understanding the injection contains glucagon, hence why it is called a glucagon injection, the hormone which is naturally produced by alpha cells, which stimulates glycogen production/release in the liver. I don't think a saline/glucose solution can be injected subcutaneously to treat hypos but it's one of the things they use to treat them intravenously if you end up needing emergency help along with glucagon as well as pure glucose injected into an iv line. I was given a huge dose of glucose into my iv when I was in dka when my bg dropped to the 40's.
Yes, I'm up on glucagon. Sorry if my post was not entirely clear.
This was a pure speculation thread... given that the problem with a hypo is low blood glucose, it seems natural that the quickest way to solve it is... with glucose. Into the blood.
Since no such first-response treatment is available for hypos, figger'd there had to be a reason -- hence starting this thread.
Jen mentioned glucotoxicity -- forgot about that, and yeah, that would nix anything other than direct injection into the bloodstream.
