Glucagon injections being discussed on FB

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Becca

Becca

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Hey everyone

I noticed this on FB today on DUK wall and it got me thinking...someone was saying about Glucagon injections and that she had never heard of them before. People commented after saying they hadn't either or that it was a funding issue?! I just had to comment:

OMG i am absolutely appalled that people are not being given glucagon injections?! It's a life preserver at the end of the day. Not all paramedics have them on board either :(

This is from NICE: "Glucagon was developed to be administere...d by people who are not health care professionals. Parents, siblings, babysitters, and other non-health care personnel can be trained by medical professionals to administer glucagon in an emergency. Administering glucagon is not complicated or difficult, and does not require medical judgment. The only possible side effects, even if given to the wrong person, are nausea and possible vomiting."

It can be carried around with you - 36 months in fridge and 18 months out of fridge or if the expiry date is sooner.

Glucagon injections can also be given in mini doses for stomach bugs etc when it's hard to raise BG levels....

But it got me thinking is this what it's like nationally? Are people being offered the glucagon when diagnosed and then being able to get it on prescription after that or are they just not being told about it? 😱

I find it really worrying....
 
Personally, I read about it (rather than being told about it), but never really considered getting it as most of the time I'd be the only person who could administer it, and I'd be the one that needed it. I didn't realise that it lasted so long out of the fridge though - might ask my GP for one when I see her next week so I can take it with me when out and about, just in case.
 
As a child I always had one in the fridge. I haven't had one for the past few years, that's my fault though. I'm about to order 2 from my GP - one for work, one for home. I would consider taking one in my bag out and about with me but I have half decent symptoms so don't feel the need.

I've had them used on me a few times over the years, it makes you feel absolutely awful after you recover, I feel sick to the stomach - my mum says it's because of the chemicals in it. Nasty stuff, but it definitely does the job when used correctly.
 
I had one when I was a teenager at home and have had them periodically since. I've lived in many different areas of the country. I have one at present, which was put on my prescription without any fuss or questions.

They do seem to be a well guarded secret though unless you find out about them yourself.

Rob
 
The first I heard of it was on dafne. They got our gps to prescribe for those of us that dont have them

My gp, and hospital had never mentioned them. I dont think many gps know what they are for either, I have been asked a couple of times on my repeats do I need any more? Like its something I use all the time.

I keep mine in the fridge and my partner knows how to use it if necessary.

I dont see the point of carrying it around or at work as no one would know I hadit or what to do with it. I presume if the worst were to happen they would call paramedics. Bit worrying to hear they dont always have it though.

Interesting to know can use to bring up bg levels if ill too, never would of occurred to me!
 
We were given 1 as part of all the paraphernalia that comes with diabetes care when we left the hospital after diagnosis and another by prescription from the doctor. I have always 2, one in my handbag (don't even take it out when my daughter isn't with me) and one in the fridge. And of course it always comes in handy having 2, when we go on holiday, as we always take double of everything just in case.

So I'm very surprised to find that not everyone has one.

Northe, wouldn't it be good for you to have one with you at all times, so that IF you'd ever need it, then at least the ambulance people will be able to use it (if they really don't have one in the ambulance).
 
I had never heard of them until I had a severe night time hypo requiring an ambulance to be called - and that was after over 20 years of having had type 1. Can't believe now that it had never been suggested. Luckily the paramedics had one with them but before they used theirs they did ask if we had our own. Obviously I was unconscious but my poor hubby just looked blank at them! Next day we went down to the drs and had no problem getting one, and no probs since then either. It's something everyone should know about and surely all paramedics should carry them as basic equipment? I wonder how we could find out whether they do or not? If they don't then we should start a campaign to change things.
 
I would imagine that paramedics do carry them, i would be very surprised if they didn't. I think they are quite expensive so they'll probably use yours if they can.

I haven't ever had one and to be honest even after having a hypo that needed A&E treatment I still don't have one. I'm really not keen on it.
 
As well as expense, the vast majority of glucagon kits pass their expiry date without ever being used, so perhaps paramedics would have used their own if it were nearer to its expiry date to the kit held by the casualty? I was told to get one by a medical adviser of an expedition company I was leading for - but there was no-one I could trust to teach to use the kit, so it expired without use, although I was able to donate it to a mountain rescue team for training purposes. I haven't had one since and have no intention of getting one. I don't want to demand an expensive and un-necessary (for me) item from the NHS. However, for people who pass into unconsciousness without realising they are going hypo, and who have someone who can administer, most of the time, then it's a different matter.
 
I have a glucagon injection at home and one at work although, thankfully, I have never needed it as yet. My brother has needed to be given the injection a few times over the years so I knew about them from him, I was never told about them when diagnosed myself. I tend to have hypos a lot and after having several very low BGs (1.8 etc) I asked my gp for glucagon injections but he was not happy about prescribing them at all. I eventually got them after telling him my DN had advised I get some.

I know they are not cheap but at the end of the day they are life savers so I do feel that all diabetics at risk of hypos should have them. I didn't know you could keep them out of the fridge though.
 
I think as well the paramedics need to be sure that Glucagon is actually going to work. If you are low for several days etc.. then glucagon injection won't work as the glucagon will be depleted in the liver so won't be able to kick any out. A glucose drip might work better if the injection doesn't work etc...

this is a link to the mini dose glucagon for stomach bugs etc...
http://www.childrenwithdiabetes.com/d_0j_20w.htm

One of the greatest challenges that parents of children with diabetes face is caring for their children when they have a stomach illness. When kids have a stomach flu and aren't able to keep food down, blood sugars can drop quickly. With blood sugars dropping and kids unable to eat, parents often resort to a trip to the emergency room for an IV of glucose or a large dose of glucagon. A new study offers an easier alternative.

A team from the Texas Children's Hospital Diabetes Care Center came up with a novel idea: use very small doses of glucagon, injected subcutaneously using a regular insulin syringe, instead of the usual large dose of glucagon given IM as a way of staving off hypoglycemia in kids with a stomach illness (gastroenteritis) or who were not cooperating and needed food. Whereas a typical glucagon injection delivers 500 to 1,000 ?g, the Texas Children's team suggested the following dosing schedule:

* 20 ?g for kids ages 2 or under, and
* 10 ?g per year of age for kids from 2 to 15 (20 ?g at age 2, 30 ?g at age 3, etc.)
* 150 ?g for kids 15 or older

Parents were instructed to dilute the glucagon as instructed in the glucagon emergency kit, but then to use a standard U-100 insulin syringe (30, 50, or 100 units) to draw up the glucagon. Each "unit" on the U-100 insulin syringe corresponds to 10 ?g of glucagon. Thus kids two or under received two "units" of glucagon, while a 10-year-old would receive 10 "units," based on the dosing schedule above. Parents monitored blood glucose every 30 minutes. If the child hadn't improved in 30 minutes, the dose was doubled and given again.

The results were excellent. Given in the doses outlined, blood sugars rose an average of 3.33-5.00 mmol/l (60-90 mg/dl) within 30 minutes and lasted for about an hour. Also, in the doses given as described, the glucagon did not cause an increase in nausea as is typical with large dose glucagon, and none of the kids vomited from the glucagon.

The team stressed that their approach is suitable for relative hypoglycemia in the face of stomach illness or lack of cooperation in eating, not unconsciousness due to severe hypoglycemia.
 
Sounds fantastic, Becca. I would definitely be willing to try that on E. I don't think people realise how difficult it can get when a diabetic child gets a stomach bug. It's not a matter of just giving the child something to keep the sugars stable. There is only so much that can be forced down when the child knows it'll be back up in twenty seconds.
I hate phoning the nurse every two minutes and being told to stay home for a little longer.
And being kids, they do get ill, no matter what you do to try to prevent it.

Luckily, we've never had to administer Glucagon and don't carry it absolutely everywhere, though we probably should. It was the first thing we were told to get after the insulins and unfortunately, also the most expensive (still under ?15).
 
shiv said:
I've had them used on me a few times over the years, it makes you feel absolutely awful after you recover, I feel sick to the stomach - my mum says it's because of the chemicals in it. Nasty stuff, but it definitely does the job when used correctly.
Click to expand...

A bit off topic, but they use exactly the same glucagon kit during CT or MRI exams of the pelvis as it relaxes the smooth muscles in the bowel, so stops the images from blurring. I wonder if that's why it makes people sick? I work with MRI and CT, and it took me by surprise a bit when I first saw the radiographers injecting one of these syringes into a conscious patient! They do check first if the patient is diabetic, so I guess they'd give some other drug if they were.
 
Don't see that many of them given to patients, mostly we give the newly diagnosed type 1s hypostop (or whatever it's called these days)/ glucogel. We have some in the fridge to somebody in the hospital must use it. I don't top up ward stock anymore, but back when i did, every ward had at least one in the fridge. I rhink we made up klits with hydrocortisone and glucose gel at Great ormond Street (errr Adrienne? Am i on the right lines here?) and i think there was a glucose injection in most crash kits. (look it's been nearly three years, and a lot of pharmacy stuff has gone into my brain since). Used to have loads in the fridge in my first hospital though, but didn't really know what it was then. I think i knew it was for diabetes, but my knowledge of diabetes was hazy at best.
 
Glucagon injections

In the past I've had a couple of Glucagon injections. The big downside is that it took almost a full day following the injections for my blood sugars to return to normal - they become very high and things aren't helped when medics advise you to have extra carbs to ensure levels don't drop again (nonsense). Had I followed one medic's advice I'd have had even higher levels than the double figures I was sent home with.

As a footnote, these dangerously low levels always came at night on an old insulin regime which helpfully 'peaked' in the middle of the night. Thank goodness for Levemir.


Becca said:
Hey everyone

I noticed this on FB today on DUK wall and it got me thinking...someone was saying about Glucagon injections and that she had never heard of them before. People commented after saying they hadn't either or that it was a funding issue?! I just had to comment:

OMG i am absolutely appalled that people are not being given glucagon injections?! It's a life preserver at the end of the day. Not all paramedics have them on board either :(

This is from NICE: "Glucagon was developed to be administere...d by people who are not health care professionals. Parents, siblings, babysitters, and other non-health care personnel can be trained by medical professionals to administer glucagon in an emergency. Administering glucagon is not complicated or difficult, and does not require medical judgment. The only possible side effects, even if given to the wrong person, are nausea and possible vomiting."

It can be carried around with you - 36 months in fridge and 18 months out of fridge or if the expiry date is sooner.

Glucagon injections can also be given in mini doses for stomach bugs etc when it's hard to raise BG levels....

But it got me thinking is this what it's like nationally? Are people being offered the glucagon when diagnosed and then being able to get it on prescription after that or are they just not being told about it? 😱

I find it really worrying....
Click to expand...
 
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