The risk of severe low blood sugar can feel overwhelming for anyone with diabetes. Also known as severe hypoglycemia, these lows occur when blood glucose drops below a certain level, causing physical and mental changes that can include headache, fatigue, seizures and even loss of consciousness. While hypoglycemia can be treated by eating sugar or a sugar-sweetened product, a severe low requires faster medical treatment — typically with a glucagon injection.
It's important for diabetes patients, their caretakers and the individuals involved in their day-to-day life to know the signs of severe hypoglycemia — so it can be quickly treated. A medication called glucagon is a potentially life-saving tool for correcting these severe lows.
Who is at risk of a severe low?
For diabetic patients undergoing treatment, those with type 1 diabetes are three times as likely to experience hypoglycemia than those with type 2 diabetes. The CDC's National Diabetes Statistics Report found that in 2016, 235,000 people went to the emergency room due to severe hypoglycemia. You may be at risk of a severe low if you:
- Take insulin or sulfonylurea to help manage diabetes
- Exercise at an intense level
- Tend to skip meals
- Have an inconsistent schedule
- Feel stressed most of the time
- Have tight blood sugar goals
- Have insulin pump problems
- Are more sensitive to insulin
Glucagon's role in raising blood glucose levels
Glucagon is a hormone that plays a critical role in quickly raising the body's blood glucose levels to restore balance. It's been around and studied since 1922. Over time, there have been three major advances in the administration of glucagon for treating severe lows:
Emergency glucagon kit
The first glucagon kit became available in 1960. These life-saving kits contain a vial of glucagon powder and a syringe filled with saline. They require preparation time and someone to administer the injection using the syringe. Eli Lilly and Novo Nordisk are two of the largest suppliers of these glucagon emergency kits, although Lilly recently announced that its kit will be discontinued by the end of 2022.
Prefilled syringe and nasal spray
As the science behind glucagon injections continued to advance, it became clear that giving diabetes patients and their caregivers an easier, faster way to administer glucagon was necessary. In 2019, pre-filled glucagon syringes became available for adults and children, as well as a needleless nasal spray, which doesn't require inhalation.
The most recent advancement in the administration of glucagon comes in the form of an autoinjector, first released in 2020. Gvoke HypoPen® (glucagon injection) is a ready-to-use glucagon injection that can be administered in two steps. Glucagon autoinjectors typically have a simpler administration process than emergency glucagon kits — they don't require mixing and have no visible needles.
From glucagon kits to autoinjectors, innovation in the treatment of severe lows has made it easier for diabetes patients and their caregivers to manage type 1 diabetes and type 2 diabetes. No matter which glucagon option you choose, the most important thing to remember is to always be prepared — so you can focus more on the people, places and activities that bring you joy.