Why you need a glucagon kit
Glucagon injection is an emergency medicine used to treat severe hypoglycemia (low blood sugar) in diabetes patients treated with insulin who have passed out or cannot take some form of sugar by mouth.
Many years ago when I lived in the UK something tragic happened at work. I was a waitress at a small neighborhood restaurant and my colleague had only been there for a few weeks, when she ordered the lunch special. The problem was this: the special was buttermilk chicken, and she was severely allergic to dairy. She went into anaphylactic shock shortly after eating it and died. How this could happen, I’m not quite sure. The chef was aware of her allergy, since they worked together every day. Being that allergic, it was also strange that she missed that her lunch was soaked in milk.
People make mistakes though, and in busy restaurants orders go wrong all the time. Think about it. How many times have you had the wrong meal served to you? Mayo when you asked for no mayo, or a plate drenched in tomato sauce even though you told the waitress you can’t stand tomatoes? It happens, and most of the time it’s not a big deal. A few months ago I went to the cinema and ordered a large diet coke from the popcorn stand. Halfway through the movie I checked my blood sugar which was at 17 mmol/l (306 mg/dl). The diet coke I’d ordered was in fact full-sugar coke, and I’d just drank a pint of it without noticing. If I had a food allergy that could kill me, I wouldn’t eat out. Ever. The risk-reward ratio is not there over a plate of food for me.
This story of my former colleague came up a few weeks ago when me and bear were discussing peanut allergy. There was one thing that always bothered me about what happened. “Since she was that allergic, where was her epipen?”, I asked the bear.
“Where is your glucagon kit?” he replied. “It could save your life just the same as the epipen could have saved hers”. He was right. When I was first diagnosed, I’d meant to get a glucagon kit. A dead in bed story I’d come across on the internet had scared the pants off me. I thought hoards of diabetics were dying in their sleep from hypoglycemia, and every night I was terrified of dozing off and never waking up again. Then other things happened and I forgot about glucagon. When I remembered again I was still alive so that bit was good. I wondered why none of the three doctors I’d seen since I got diabetes had mentioned the glucagon kit. Surely everyone on insulin should keep one in their house? It might save your life.
So when I went to see my endocrinologist last week I asked for one, which she prescribed straight away. It now lives in my refrigerator and is valid until 2022. A few things about glucagon to be aware of. It’s a hormone that works by telling the liver to release more glucose into the blood. If you’re drunk the liver is busy with detoxification, and injecting glucagon won’t raise blood glucose. Also the kits need reconstitution, here’s a short video on how it’s done:
People tend to panic in emergency situations, so make sure the person who would inject you with glucagon if necessary knows how it’s done. I read a heartbreaking story on a Czech diabetes forum about a mother who forgot to mix the saline and the glucagon powder, and simply injected saline. Her child died (which might have happened anyway, but imagine how you’d blame yourself). It’s an easy mistake to make if you’re faced with an unconscious diabetic and have to act on the spot.
Last month a premixed, single-step glucagon injection, GVOKE, came out on the market. It solves this problem, and will probably become the new standard. If like me you have a kit from NovoNordisk or Lilly, keeping a backup or some extra saline in the fridge is a good idea. Because mistakes happen, and I’m a firm believer in second chances. Especially when it comes to saving somebody’s life.