Glucagon for Severe Low Blood Sugar: Gvoke, Baqsimi, Zegalogue and Kits

What glucagon does

Your pancreas makes glucagon to tell the liver to release stored glucose. As a medicine, it does the same thing quickly. The NIDDK calls it the best way to treat severely low blood glucose and says family and friends should be taught when and how to give it. The ADA lists a severe low, level 3, as an event needing another person’s help, and says glucagon is indicated for people who cannot or will not take carbohydrate by mouth. People giving it do not have to be health professionals. The ADA prefers ready-to-use forms that need no mixing, and intranasal and ready-to-inject forms for faster correction.

FDA-approved forms

Facts below are from each product’s FDA-approved label on DailyMed or Drugs@FDA. There may be other brands of kit and generics.

Label contents change; check the current label and your pharmacy’s product. Some glucagon products are also approved as a diagnostic aid for imaging, which is a different use.

Things the labels say

• Who should not use it. The labels list a tumor of the adrenal gland (pheochromocytoma) as a reason not to use glucagon, and Zegalogue’s also lists insulinoma. Tell your prescriber about your health history.
• It may not work if the liver has little stored glucose, for example with starvation, adrenal insufficiency or chronic low glucose, according to the Gvoke and Zegalogue labels. The person may then need glucose by other means, which is why 911 is called.
• Allergic reactions are possible. The Gvoke label lists rash, and in some cases anaphylaxis, among reported reactions.
• It comes in single-use devices. Each product has its own instructions for use. Learn yours before you need it.

Being prepared

1. Ask your care team whether glucagon is right for you. The ADA says it should be prescribed for everyone on insulin or at high risk.
2. Teach the people around you where it is kept and how to use it, as the ADA recommends for family, caregivers and school staff.
3. Check the expiry date and storage on the label, and replace when needed.
4. Practice with the maker’s trainer or video if there is one; ask your pharmacist.
5. Tell your care team after any severe low. They will want to review your plan.

Glucagon is for severe lows only. For mild and moderate lows, use the rule of 15 with glucose tablets or other quick carbohydrate. Know the signs on the low blood sugar symptoms page.

Information only, not medical advice. Your care team may set different targets for you, and only a lab test ordered by a clinician can diagnose diabetes or prediabetes. See our medical disclaimer.