Glucagon (Injection)

Overview

As one of the main catabolic hormones in the body, Glucagon helps to increase levels of fat and glucose in the bloodstream. Produced by alpha cells in the pancreas, Glucagon is normally released when glucose levels in the blood begin to fall. In healthy patients, Glucagon is converted to glucose by the liver and then released into the blood, thus preventing hypoglycemia from occurring.

In diabetic patients, however, the level of glucose in the blood is not controlled well. Whilst some patients may have too much glucose in their blood, others can have dangerously low levels of glucose. When the patient's glucose levels fall too low, they can experience a range of symptoms, such as nervousness, trembling, blurred vision, headaches, increased heart rate and weakness. If untreated, extremely low glucose levels can cause the patient to lose consciousness and fall into a diabetic coma. As a diabetic coma is a life-threatening condition, it's vital that treatment is administered quickly and the patient's glucose levels are increased to a safe level.

When diabetic patients realize their blood sugar levels are low, they are usually able to increase them by eating something containing sugar. However, if the patient has lost consciousness or is unable to ingest anything orally, a Glucagon injection can be used to increase their glucose levels.

By adding Glucagon to the body, this injection can raise the patient's blood glucose level and reduce the symptoms of hypoglycemia. If the patient has yet to fall into a diabetic coma, this can be prevented by the use of a Glucagon. Although effective in treating hypoglycemia, Glucagon injections are used in emergency situations only. Diabetic patients may be prescribed this type of injection for emergency use but they are not typically used to control the patient's blood sugar levels.

As well as being used to treat hypoglycemia in diabetic patients, Glucagon injections can be used during x-rays of the bowels and/or stomach. As the medication relaxes the muscles, it can allow physicians to examine the area more clearly and can, therefore, increase the accuracy of diagnostic imaging tests.

Conditions Treated

  • Low blood sugar (Hypoglycemia)
  • Diagnostic aid

Type Of Medicine

  • Hormone

Side Effects

When patients are prescribed medications, it's not unusual for them to experience some side-effects. These can be more prevalent when the medicine is first used but may decrease over time. Although it's not particularly common for patients to experience side-effects after being treated with Glucagon, it is possible. If patients experience the following side-effects after being given a Glucagon injection, they should seek medical assistance:

  • Anxiety
  • Vomiting
  • Blurred vision
  • Swelling or puffiness around the eyes or on the eyelids, eyes, lips, tongue or face
  • Slurred speech
  • Chills
  • Sweating
  • Pounding in the ears
  • Shakiness
  • Cold sweats
  • Skin rash, itching or hives
  • Nightmares
  • Coma
  • Seizures
  • Lightheadedness, faintness or dizziness when getting up suddenly from a sitting or lying position
  • Confusion
  • Unusual tiredness or weakness
  • Nervousness
  • Pounding, irregular or fast pulse or heartbeat
  • Cool, pale skin
  • Tightness in the chest
  • Nausea
  • Depression
  • Increased hunger
  • Dizziness
  • Headache
  • Fast heartbeat
  • Slow heartbeat

In addition to this, patients should obtain medical assistance if they experience any other adverse effects after being treated with Glucagon.

Dosage

When patients are prescribed Glucagon, they should ensure that they are aware of what dosage to use in an emergency situation. Generally, adult and pediatric patients over the age of six years are advised to administer 1 milliliter of Glucagon, providing they weigh over 25 kilograms. If necessary, this dose can be repeated while emergency medical assistance is on the way.

If pediatric patients under the age of six and/or weighing less than 25 kilograms are treated with Glucagon, they are usually given 0.5 milliliters of the medicine.

When Glucagon is administered, it should be given in injection form and the injection should be under the patient's skin, into a muscle or into a vein. When Glucagon is prescribed, the patient should be shown how to administer an injection so that they are aware of what to do if an emergency situation arises. In addition to this, the patient's family and/or close friends should be shown how to administer this medication. This ensures that the patient can be treated if they lose consciousness due to hypoglycemia.

As soon as the medication has been administered, the patient or someone close to them should call for emergency medical help. It is appropriate to call 911 for assistance in this situation.

Glucagon should not be used if a gel has formed in the medicine or if particles are present in the solution. Patients should inspect their medicine at regular intervals to ensure it can be used if an unexpected medical emergency occurs.

Following the Glucagon injection, patients should drink a fast-acting source of sugar, if they are able to swallow safely. This may be a fruit juice or regular soft drink. In addition to this, patients should consume a long-acting form of sugar as soon as they are able to do so safely.

Patients should make sure that they know when to use Glucagon and how to administer an injection when they are prescribed the medicine. If they are unsure, they should seek advice from their physician before an emergency situation arises.

Potential Drug Interactions

As some medicines can interact with each other, patients may not be prescribed Glucagon injections if they are using certain other medicines. Due to this, it's important that patients tell their physician what medicines they are taking before Glucagon is prescribed to them.

If Glucagon injections are used alongside the following medicines, it may increase the risk of the patient suffering side-effects:

  • Acenocoumarol
  • Warfarin
  • Phenindione
  • Anisindione
  • Phenprocoumon
  • Dicumarol

Although side-effects may be more likely to occur if Glucagon is administered in conjunction with the above medications, this is not normally a cause for concern. If necessary, doctors will modify the patient's dose of medicine in order to reduce side-effects or provide additional medication to relieve any side-effects which do occur.

As Glucagon injections are used in an emergency, the patient's doctor will ensure that the medication can be administered safely when it is prescribed.

However, over-the-counter medicines, vitamins and supplements could also interact with Glucagon. Patients should, therefore, tell their physician if they regularly take or use any of these substances. In addition to this, patients should seek medical advice before using any new medicines, supplements or vitamins, in case they need to administer a Glucagon injection at any point.

Warnings

If patients have any existing medical conditions, it may affect their use of Glucagon. Due to this, patients should disclose their full medical history to their physician when Glucagon injections are prescribed. The following conditions, in particular, may affect the patient's use of Glucagon:

  • Coronary artery disease
  • Heart disease
  • Glucagonoma
  • Allergy to lactose
  • Allergy to glucose
  • Adrenal gland tumor (Pheochromocytoma)
  • Insulinoma

Patients should be familiar with the symptoms of low blood sugar. If left untreated, symptoms could lead to seizures, unconsciousness and death. Symptoms may include:

  • Anxiety
  • Unusual weakness or tiredness
  • Slurred speech
  • Blurred vision
  • Shakiness
  • Changes in behavior (patient may appear drunk)
  • Restless sleep
  • Nausea
  • Nightmares
  • Nervousness
  • Headache
  • Fast heartrate
  • Increased hunger
  • Cold sweats
  • Pale, cool skin
  • Confusion
  • Drowsiness
  • Difficulty concentrating

Symptoms of low blood sugar can occur very quickly and may be caused by any of the following:

  • Excessive use of insulin
  • Missing or delaying a meal or snack
  • Exercising too much
  • Sickness (Such as diarrhea or vomiting)

Patients should learn to recognize their symptoms of low blood sugar. Often, eating or drinking a fast-acting sugary drink or snack will prevent symptoms from worsening and may mean that Glucagon doesn't have to be used. Patients may find the following items a good source of sugar:

  • Fruit juice
  • Non-diet soda
  • Honey
  • Sugar cubes
  • Corn syrup
  • Glucose tablets or gels
  • Table sugar dissolved in water

If the patient's next meal is not due within one hour, patients should also eat a light snack as this can prevent their blood sugar levels from dropping again. Patients may benefit from eating a sandwich, crackers and cheese or drinking a glass of milk.

If patients are experiencing the symptoms associated with low blood sugar, they should not eat mints or hard candy as the sugar will take too long to take effect. Similarly, patients should not use foods with a high fat content, such as chocolate, when trying to raise their blood sugar levels. Generally, high levels of fats prevent sugar from taking effect quickly and may prevent the patient's blood sugar levels from being raised quickly.

After patients have recovered from an episode of low blood sugar, they should check their blood sugar levels again within ten to twenty minutes of the first incident. This enables them to ensure that their blood sugar is at a safe level and isn't dropping again.

Patients should not attempt to drive, use machinery or carry out tasks which require their full attention when they are experiencing the effects of low blood sugar. During this time, patients may feel dizzy or drowsy and it would be unsafe to carry out these tasks.

If patients do not notice an improvement in their blood sugar levels after eating and/or drinking, they must notify a healthcare practitioner immediately.

If the patient loses consciousness or experiences seizures, no-one should attempt to give them anything to drink or eat. As the patient will be unable to swallow, attempting to force them to eat or drink could cause them to choke. Instead, a Glucagon injection should be administered and emergency medical help should be sought.

After a Glucagon injection has been administered, the patient should be laid on their left side. If the patient experiences vomiting as a side-effect of the medication, laying them in this position will help to prevent choking.

After Glucagon has been injected, the patient should regain consciousness within fifteen minutes. If the patient is still unconscious after this time, another dose of Glucagon can be administered.

Glucagon is only effective for approximately one and a half hours. As soon as the patient is conscious and able to swallow they should be given something to eat and/or drink. This will help to prevent another period of hypoglycemia occurring.

After a Glucagon has been administered, the patient or their caregiver should monitor the patient's blood sugar level. Their levels should be monitored at least once per hour for three to four hours following the injection.

If patients experience nausea and/or vomiting as a side-effect of Glucagon, they may be unable to eat or drink. Medical help should be sought so that another period of hypoglycemia can be avoided.

Even if Glucagon successfully treats the patient, they should seek medical assistance after an episode of severe hypoglycemia. In addition to this, patients should notify their usual physician so that a record can be kept of their treatment.

If patients have used Glucagon, they should replace their supply of the medicine as soon as possible. This will ensure that the patient has an adequate supply of medication if further episodes of hypoglycemia occur.

Diabetic patients should wear a medical identification bracelet at all times as this helps alert others to their condition. In addition to this, patients should carry a medical identification card stating their diagnosis and an up-to-date list of the medications they are taking. This information should also state that the patient carries Glucagon and that emergency medicine may be required.

It is not known whether Glucagon could cause harm to an unborn fetus if it is administered to a pregnant patient. If patients are pregnant or plan to become pregnant, they should discuss the use of Glucagon with their physician.

Although some medicines can be transferred to an infant via breastfeeding, it is not known whether Glucagon can be transferred in this way or if it is likely to cause harm to an infant. Due to this, patients may be advised not to breastfeed after being treated with Glucagon. Patients should always seek medical advice before breastfeeding if they have been treated with this medication.

If patients exhibit an allergic reaction after being treated with Glucagon, they will require emergency treatment. The symptoms of an allergic reaction may include:

  • Difficulty breathing
  • Wheezing
  • Itching
  • Hoarseness
  • Hives
  • Difficulty swallowing
  • Swelling of the hands, face, throat, mouth, lips and/or tongue

Storage

When patients are prescribed Glucagon, they are advised to carry the medicine with them at all times. This ensures that Glucagon will be accessible to them in the event of a sudden episode of hypoglycemia.

However, it is vital that patients keep the medicine in a secure location so that no-one else can gain access to it. It is particularly important that children and/or animals cannot gain access to Glucagon.

When storing Glucagon, patients should follow the manufacturer's instructions. However, the medicine can usually be kept at room temperature, providing it is away from heat, moisture and direct light. Glucagon should not be kept in locations where excessive temperatures may occur, such as in a vehicle.

When patients need to dispose of Glucagon, they should not throw their medication out with other household waste. Instead, patients should contact their physician's office or pharmacist and make use of a specific medicine disposal service.

Summary

Although diabetic patients can often control their condition with medication and diet, sudden changes in their blood sugar level can still occur. If patients administer too much insulin or go too long without eating, for example, their blood sugar level could drop dramatically.

If patients identify the symptoms of low blood sugar quickly enough, they may be able to treat it effectively by consuming fast and long acting foods and drinks. However, if this is ineffective or if the patient is unable to swallow, Glucagon injections can be used.

By administering Glucagon, patients can increase their blood sugar level quickly and prevent the symptoms of hypoglycemia from occurring. Although the medicine should not be used as a regular form of blood sugar control, it can be used effectively in an emergency situation.

If untreated, low blood sugar levels can have serious consequences and may even be life-threatening. Due to this, patients and their caregivers should be aware of how to use the medicine and when to administer an injection. Providing the patient carries a Glucagon supply with them at all times, this medicine can be used to prevent serious symptoms of hypoglycemia occurring.