Glucagon

[newbs]

Just a quick question - I've been prescribed Glucagon for use if I have a hypo like on Thursday where my BG doesn't respond to oral glucose - I've been told to make a nurse appointment for myself and OH to be taught how to administer it - is this really necessary? Is it not something you would just jab in in an emergency?

 

[Lauras87]

I thought it could only be given if we were unconscious.

Mum was trained how to use it on me but never has.

I've wondered about using it when hypo & my bloods won't behave but I don't know what to do.

Maybe if you aren't responding it would be best to use it, I hope your body does respond next time

 

[newbs]

I thought it could only be given if we were unconscious.

Mum was trained how to use it on me but never has.

I've wondered about using it when hypo & my bloods won't behave but I don't know what to do.

Maybe if you aren't responding it would be best to use it, I hope your body does respond next time

That's what I always thought - you had to be unconscious. But I guess if it's heading that way ... maybe it'll be worth being shown how to do it. I've heard it makes you really ill for a day afterwards though.

 

[Lauras87]

That's what I always thought - you had to be unconscious. But I guess if it's heading that way ... maybe it'll be worth being shown how to do it. I've heard it makes you really ill for a day afterwards though.

Really? Doesn't sound good, I hope that's not the case. As having a low hypo wipes the floor with you anyway

From what mum told me it has to be done based on body weight & done in the upper leg straight into the muscle (I'd rather let a paramedic do it as knowing me I'd miss)

But I hope the training goes well 🙂

 

[HOBIE]

Have got some in the fridge but never used. Have you tried hypostop. Comes in a toothpaste like tube & is administerd easily. Belive it or not i am quite strong & wife gets in to me when i am being stroppy. Tastes nice not like pukozade 🙄 Good luck with next app 😉

 

[newbs]

Have got some in the fridge but never used. Have you tried hypostop. Comes in a toothpaste like tube & is administerd easily. Belive it or not i am quite strong & wife gets in to me when i am being stroppy. Tastes nice not like pukozade 🙄 Good luck with next app 😉

I have tried hypostop, don't like it but would prefer it to glucagon, should get some more really. Not sure it would do the trick if lucozade won't though.

 

[Lauras87]

Have got some in the fridge but never used. Have you tried hypostop. Comes in a toothpaste like tube & is administerd easily. Belive it or not i am quite strong & wife gets in to me when i am being stroppy. Tastes nice not like pukozade 🙄 Good luck with next app 😉

Don't you throw up from hypostop? I do if I have to use it, the texture is horrid.

Gluco juice is good but not cheap to buy

 

[Northerner]

I would say it's definitely worth learning how to use it and having some to hand, but obviously your husband would only want to administer it if he thought absolutely necessary. It's like the opposite of insulin, and is actually naturally produced by the alpha cells of the pancreas when a non-diabetic's blood sugar levels fall too low - for us this may happen, but is a faulty mechanism so cannot be relied upon to bring us out of a hypo. It stimulates the liver to release glucose in order to raise levels. However, this will leave the liver depleted of stores so you do have to be careful afterwards as the glucagon would only be able to be used again after 24 hours when the stores have been replenished 🙂

 

[Redkite]

Hi Newbs,

We have glucagon for my son, and some members of school staff are trained to use it as well. It is to be used in the case of a severe hypo where you are unable to swallow (you could still be conscious). It comes in the form of a vial of powder and a syringe of purified water. The water has to be injected into the vial, which must be shaken up to dissolve the powder, then the solution needs to be drawn back up before it can be injected. So it isn't as simple as an epipen which you just jab in.

It works by stimulating the liver to release stored glucose; however it would have no effect if stores had been used up by repeated hypos in the preceding couple of days, and may also have no effect if you had been drinking alcohol. Injecting glucagon nearly always leaves the person feeling sick, so the protocol is to place them in the recovery position after injecting.

It's a safety net 🙂

 

[PattiEvans]

Newbs. I think we attend the same clinic and I've just done the course nominally called "carb counting". We discussed Glucagon injections and I do think your nearest and dearest need to be trained. What Northerner says is correct. You need also to know how to manage the 24 hours after the emergency. Contact Treliske!

 

[Tina63]

If you have a Glucagon kit, it has very explicit instructions inside the case of what exactly to do. We have never had to use it on our son, and were only very briefly told about it but never shown it open, and it was some months after diagnosis that I actually opened it and looked at it in some detail. It may well be worth you and OH doing that now. I have to admit I was shocked at the size of the needle.

As Redkite said, it has to be mixed first. I am not sure how efficient I would be in an emergency, I tend to get the violent shakes, so could be interesting if and when I ever had to do it!

What I did do was wait until our kit was close to expiry, ordered a new kit, then experimented with mixing the old one so I knew what to do. So I am now at least armed with the knowledge.......

 

[Copepod]

As Redkite says, practicing with an expired (or training kit) is vital, as an emergency is not the time to read instructions and fiddle with vial and syringe.

The training with DSN should show you how to mix and inject glucagon, but as you'll never do that for yourself - either you're conscious enough to swallow sugary drink / gel etc or you're too unconscious to swallow and thus also too unconscious to mix and inject an injection - intramuscular, hence larger needle than subcutaneous for insulin. So, best to take along whover might inject for you - husband / OH / parent etc.

 

[Tina63]

Injecting glucagon nearly always leaves the person feeling sick, so the protocol is to place them in the recovery position after injecting.

And have a bucket close by

 

[Pumper_Sue]

I used it once when concious as couldn't get my blood sugars to rise.This was pre addison's diagnoses as it can not be used on people with adrenal disfunction, so can never use it again.
It is idiot proof to use as in one vial of liquid and one of powder, so just draw up the liquid into a syringe and insert into powder vial then draw the lot into the syringe and inject into the muscle. The needle size will cure any hypo 😱
Instead of hypo stop which is disgusting and very expensive buy yourself some liquid glucose, which is found in the cake making department. It has a pleasent taste and obviously pure glucose it just melts in the mouth.

 

[redrevis]

It is idiot proof to use as in one vial of liquid and one of powder, so just draw up the liquid into a syringe and insert into powder vial then draw the lot into the syringe and inject into the muscle.

The liquid is already in the syringe and there's only 1 vial with a tablet in it 😉 You pierce the vial and fill with the liquid from the syringe, then leave the syringe in the vial whilst shaking the vial until the mixture turns clear. With the syringe and vial upside down, draw the liquid back into the syringe, making sure you slowly pull out the syringe as the liquid decreases in order to not just fill it with air and actually remove all the liquid. Then hold the syringe upside down whilst flicking to bring the bubbles to the top, then slightly depress the syringe to remove any air from it. Then stab into the bottom half of the thigh or buttocks and depress the syringe fully. So not exactly idiot proof, especially if you're panicking at the time due to the person needing it being unconscious.

Me and my fianc?e sat down this weekend with an expired one for her to practice. The first thing she said was that is wasn't as easy as she'd imagine and that if the first time she did it would have been in a real situation that she'd have been useless. But now she would be very confident.

 

[Pumper_Sue]

The liquid is already in the syringe and there's only 1 vial with a tablet in it 😉

I haven't used one for 20 years, so things have changed since then but principle is exactly the same....... Liquid into powder 🙂

 

[DeusXM]

There always seems to be a lot of panic over hypos and what you need to correct them.

The glucagon pen is the Alamo - it's what someone else gives you if you pass out and isn't meant for normal hypo treatment.

Similarly, there's no real need for all these special hypostop gels etc. While these will work, the principle behind a hypo is usually very simple. There isn't enough glucose in your blood, so you need to get glucose into your blood. Any sugar you put in your mouth will end up in your blood so a hypo (usually) is dead easy to treat by eating or drinking something that is high in sugars and low in everything else - regular soft drinks can work absolutely fine for this.

I agree there is a time and place for things like hypostop gel or glucagon but in general these can be completely avoided as unnecessary and overcomplicated.

 

[newbs]

Any sugar you put in your mouth will end up in your blood so a hypo (usually) is dead easy to treat by eating or drinking something that is high in sugars and low in everything else - regular soft drinks can work absolutely fine for this.

This is the problem, the things I have put in my mouth have not brought my BG up as they should - leading to my DSN thinking I have gastroparesis. The glucagon has been prescribed for the situation where nothing else is bringing my BG up, no matter how hard I try.

 

[AJLang]

Hi I just want to reiterate what Newbs has said. The hypo occurs after you've eaten a meal which hasn't been digested quickly enough because of the gastroparesis. Often after your evening meal as your tummy still hasn't properly digested your meals from earlier in the day. You therefore have a stomach full of undigested food which it is extremely difficult for the Lucozade or any other sugary substance to get through. It can take 2-3 hours and a mega amount of Lucozade or similar to get the BG back up to around 5. Then when everything digests a few hours later you get a mega high BG. It is really horrible which is why the multiwave on the pump is so useful.

 

[everydayupsanddowns]

One of the things I've seen mentioned on several occasions is that things like liquid glucose/glucogel can transfer into the bloodstream through the tissues of the mouth/gums.

Does anyone know how effective this is? Would it be better for a person with gastroparesis to try to hold the glucose in the mouth as long as possible?