Glucagon and Diabetes

Glucagon is a hormone made by the pancreas that raises blood sugar levels. A manmade version is used as a medicine to treat very low blood sugar levels in people with diabetes.

How Does Glucagon Work?

An important job of the pancreas is to make glucagon (GLOO-kuh-gon). Normally, when blood sugar levels get low, glucagon goes into action and helps get them back up into a healthy range.

When someone without diabetes has low blood sugar, their natural glucagon begins to work to raise their blood sugar. They also can eat or drink something sugary if they need to.

But when a person with diabetes has low blood sugar (hypoglycemia), their natural glucagon doesn’t work as well. If their blood sugar gets very low, they may get very sleepy, agitated, or confused or pass out. It isn’t safe for a person who isn’t fully awake or aware to get sugar by eating or drinking. They need a dose of glucagon to get their blood sugar up. It usually does this within 15 minutes.

How Do I Get Glucagon?

Your child’s doctor will prescribe glucagon. Keep it in the diabetes to-go kit so it’s always with your child. You can also ask the doctor for an extra dose to keep at school, or anywhere else your child spends a lot of time.

Glucagon comes in different forms:

• a powder that you mix with saline and inject with a syringe (needle)
• a premixed and filled syringe ready to inject
• an autoinjector
• a nasal spray

Talk to your doctor about which type is best for your child. When you get the glucagon, read the instructions carefully so you will be ready to use it in case of an emergency.

When Should I Give My Child Glucagon?

Give glucagon right away if your child has signs of low blood sugar and can’t take sugar by mouth.

Sometimes the signs of low blood sugar are severe and the need for glucagon is very clear, like your child is unable to wake up or has a seizure. Give glucagon right away.

Sometimes low blood sugar causes less severe signs, such as: 

• shakiness
• moodiness
• fast heartbeat
• pale, sweaty skin
• headache
• extreme hunger
• blurred vision
• lightheadedness
• tiredness
• nightmares

If your child has any of these signs and is confused or vomiting and can’t swallow sugary drinks or glucose safely, you will need to give glucagon.

How Do I Give My Child Glucagon?

• Don’t delay. Give glucagon and call 911. Your child should be more alert and feel better within 15 minutes. This can feel like a long time. The 911 operator can help you during this time.
• Check the blood sugar. If you haven’t already, check your child’s blood sugar right after giving glucagon and then again in 15 minutes.
• When your child is awake and can swallow, give fast-acting sugar by mouth. Offer your child a sugary food or drink that will raise their blood sugar quickly. Regular soda, orange juice, or cake frosting are good choices. Or, give your child a glucose tablet or gel. This will help prevent the blood sugar from falling again.
• Give longer-acting sugar as soon as you can. Good options include cheese and crackers, peanut butter and crackers, or half a turkey sandwich.
• Tell the doctor who manages your child’s diabetes that you gave glucagon. An episode of severe low blood sugar could be a sign that they need to adjust your child’s insulin or another part of the diabetes care plan.

What Else Should Parents Know?

Nearly every child with diabetes will have a low blood sugar at times. The key is to know the symptoms of hypoglycemia and catch it early if you can. If hypoglycemia becomes severe, you need to be ready to give your child glucagon.

• Prepare caregivers. Make sure that everyone who cares for your child has your child’s emergency supplies handy and knows how and when to give glucagon. Babysitters, adult family members, school staff, and other caregivers also should know when to call 911 for hypoglycemia emergencies.
• Check glucagon expiration dates. Check your child’s diabetes to-go kit every 6 months and make sure the glucagon hasn’t expired. Add a note to your calendar to refill the prescription 1 month before the expiration date.
• Store glucagon safely. Keep your child’s glucagon at room temperature and in their original package.
• Follow the diabetes care plan. Give diabetes medicines as prescribed to lessen the chances of problems. If you have questions about diabetes medicines, talk to your doctor or the diabetes health care team.