Liquid Stable Glucagon from Xeris

I did it as a test of expired glucagon, and was also doing mini-doses of it. It was 3 years past expiration.

On the first day, I went from 51 to 109, and that was with just 25 units.

Then I tried it a few days later and it still worked. I actually got 5 days out of it before it stopped working, not 3 days. I forgot a little about the details.

Here are the details:

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I think I took a 10 or 15 unit dose in an insulin syringe. Interesting that the shelf life is significantly understated.

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Just like insulin. I guess they just need to say that. I have used insulin that was even older than that, and it worked fine.

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I do, too. But a CDE pointed out several years ago that it’s useful to keep glucagon on hand for mini-dosing. I also take one when I travel (on one trip I had an upset stomach and was low for about four hours…it would’ve come in handy then).

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Do you know why? That’s a big drop.

What is the purpose of mini dosing with it, instead of just drinking juice or something?

Mini-doses of glucagon can come in handy when the diabetic throws up a meal after taking a full dose. This circumstance is faced often by parents of young children with diabetes.

Drinking juice or eating some other simple carbohydrate once in a while works OK. Have you ever thought about the total calories you consume with these corrections over time?

I correct for mild hypoglycemia many times per week. I carry an unneeded 10 pounds of body weight; I certainly don’t need to add more calories and make it even harder to lose that weight. Treating hypoglycemia with the traditional methods can make that extra 10-20 pounds many of us carry very difficult to lose.

This is a good resource. I followed a similar set of instructions posted by another hospital in Canada, perhaps from Manitoba. Here’s a study posted by the ADA.

Edited to add: Here’s the protocol I followed. It is published by McMasters Children’s Hospital in Ontario, Canada.

Phew, that’s a relief. I’ve never refrigerated mine, never had to use it either deo gracias. I’m quite certain that if I ever got the state of needing it I’d be completely unable to remember or carry out the procedure and I doubt my wife would either. But I have one! Hope this new product works out.

For me they are quite cheap with insurance. If it is the same for you, when it expires, get a new one and take the old kit and work through it with your wife and let her practice the steps (not injecting it in you though!).

She should know how to do it. Have her practice it so she is not afraid to use it. It’s really a better alternative than calling 911.

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Yeah, and now they’re back up. Only thing I can think of are a) hormone, b) warmer weather (temporarily), c) infusion set location, and d) starting a new steroid medication. Unfortunately, changes of that amount are fairly routine for me.

I thought that the glycogen your liver dumps from the use of glucagon would still be considered extra calories since it raises glucose in your blood just like the sugar in juice does after it gets converted to glucose. Extra calories due to hypo corrections are something I try to pay attention to (I am a bit overweight and struggle quite a bit trying to lose even 5 pounds, but I ant to lose about 40-50…) so I have worked to avoid lows and have gotten pretty decent at it, but that also means I am less aggressive with boluses sometimes which can mean more highs. Not sure how i would feel about the extra injections though…

You make a good point, one I hadn’t considered before. Maybe whether the glucose comes from eating or from the liver’s store doesn’t matter nutrition or weight-wise. This study has not likely been done. Perhaps when room-temperature stable liquid glucagon becomes available, this study could be done.

I wonder if the glucagon-induced liver glucose overall better matches the hypo challenge and therefore does not over-treat like many of us do with food-based treatments.

That doesn’t make a lot of sense to me (not saying your hypothesis is incorrect), but my gut tells me that you have to either ingest calories by eating or by a feeding tube, OR you have to get nutrients through an IV. What is already in your body, including what is stored in liver, can’t increase your body weight, just by forcing it to release carbs into the bloodstream. Someone who has more time to investigate, I’ll bend to your research results. :slight_smile:

I’m still thinking about this point you made. I’m not a biochemist and it might take someone with that level of expertise to provide a definitive answer.

I do know that once the glycogen in the liver is dispensed, the liver will replenish that deficit when more glucose becomes available through normal nutrition. I think that the glycogen released is roughly equal to the glycogen replenishment with the net glucose effect being zero, or there about since there is usually some energy expended in the process.

So for now I’ve returned to thinking that mini-glucagon doses for mild hypoglycemia are better than glucose tabs or food for avoiding weight gain in the long run. Does that make any sense?

Yeah now that you all put it like that I think that is probably true. Since it is already in your body, it probably won’t be converted into more fat, unless it combines with other substances that would otherwise be expelled. I guess that could still be possible. I don’t know enough about the chemistry of how everything gets turned into fat to be able to put up any kind of argument here so I will patiently wait for someone else to figure it out lol.

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The total weight associated with liver glycogen is trivial. Generally the liver stores about 100 grams of glycogen. That glycogen is hydrated at about a 3 to 4 part ratio.

So 100 grams of liver glycogen, at most if hydrated at the highest ratio would be equal to 500 grams. That’s about 1.1 pounds.

But your body is not going to release that and not get it back. It will do whatever it can to replace that liver glycogen. Either through glycogenesis or gluconeogenesis.

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