Glucagon for Children

What is glucagon?

Glucagon is a hormone that the body makes naturally to raise low blood sugar. It’s also made as a medicine to treat very low blood sugar (hypoglycemia) in people with diabetes.

In kids with type 1 diabetes, their body might not be able to release enough natural glucagon. When their blood sugar drops, it can become a medical emergency. Severely low blood sugar can cause a range of symptoms from headache and confusion to seizures, fainting or even death. That’s why it’s important for families to always keep glucagon with them.

Why is glucagon important?

Glucagon acts quickly to raise blood sugar when levels fall too low. If a child has fainted or has a seizure, they might not be able to eat or drink safely. A glucagon dose by injection or nasal spray can raise blood sugar within about 15 minutes. This rescue treatment brings blood sugar into a safe range until the child can eat, drink or get medical help.

What are the different types of glucagon?

Glucagon comes in different forms. Your child’s care team will help you understand which type is best for your child, based on their age and health needs. We’ll train you and other caregivers on how to use each type and give you a diabetes action plan to follow in an emergency. With practice, you can feel confident using any form of glucagon.

Traditional glucagon injectable kits

Glucagon injection kits come with a vial of powder and a syringe filled with liquid. A caregiver mixes them and then injects the medicine into a child’s thigh or arm.

Prefilled glucagon autoinjectors or syringes

These single-dose devices contain glucagon that’s already mixed and ready to use. A caregiver can quickly inject the medicine in just two steps. Watch this brief video on how to use prefilled glucagon injectors.

Glucagon nasal spray

Nasal glucagon is a needle-free option. It delivers a single dose via a spray into the nose. The glucagon nasal powder quickly absorbs into the bloodstream to raise blood sugar. Caregivers can use nasal glucagon when a child can’t swallow, is unconscious or is having a seizure. See more details on how to use glucagon nasal spray.

Mini-dose glucagon

If your child is awake but can’t swallow or keep food or drink down, a low dose of glucagon may be an option. A mini-dose injection can raise their blood sugar before it becomes dangerously low. Our team will tell you if this treatment is right for your child and give you written instructions on when to use it.

When should glucagon be given to a child?

Give your child glucagon right away if they have signs of severely low blood sugar and can’t eat or drink glucose or something sugary. A child needs glucagon if they:

• Cannot swallow

• Are unconscious (can’t wake up)

• Are having a seizure (sudden, quick movements that they can’t control)

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

• Shakiness

• Extreme hunger

• Headache

• Sleepiness

• Moodiness

• Fast heartbeat

• Pale, sweaty skin

• Blurred vision

• Lightheadedness

• Nightmares

You’ll need to give glucagon if your child has any of these signs and is confused or vomiting and can’t swallow sugary drinks or glucose safely.

What are the benefits of glucagon?

Having glucagon on hand – at school, at home and on-the-go – can give you and other caregivers peace of mind. And knowing how to use glucagon helps children avoid life-threatening episodes of low blood sugar.

Glucagon supports your child’s health by:

• Quickly raising blood sugar during a severe low to help stop a seizure or fainting episode.

• Enabling parents, school staff, coaches and other caregivers to act fast in an emergency.

• Helping kids feel safe when they take part in sports, sleepovers, field trips and other activities.

• Providing multiple treatment options, including injectables and a nasal spray.

At Children’s Health, you can practice with our team until you feel comfortable and confident using various glucagon options. And if your child does have a severe low blood sugar episode, we review their care plan to help prevent future emergencies. We may adjust their insulin dose and recommendations for meals or physical activity.

What are the side effects of glucagon?

Most children do well with glucagon. Any side effects are usually mild and temporary. At Children’s Health, we’ll teach you what side effects to watch for and when to call the care team.

Possible glucagon side effects include:

• Nausea or vomiting

• Headache

• Change in the ways things taste or smell

• Dizziness or lightheadedness

Other possible side effects of injectable glucagon may happen around the injection site, such as:

• Redness

• Swelling

• Soreness

Other possible side effects of nasal glucagon include:

• Sore, itchy or irritated nose or throat

• Runny nose

• Watery eyes

What are the risks of glucagon?

Serious risks from glucagon are rare. But it’s important for families to know about them. The main risk is an allergic reaction that may cause:

• Rash, itching or hives (raised, itchy bumps)

• Swelling of the face, eyes, lips, tongue or throat

• Trouble breathing or swallowing

Your child’s care team at Children’s Health helps reduce possible risks:

• We carefully review your child’s medical history to prescribe safe treatment options.

• We provide hands-on training and written instructions to help make sure you’re giving your child the correct doses.

• We outline clear steps for when to call 911 and how to follow up with our team after any severe low episode.

How do I give my child glucagon?

Glucagon is for low blood sugar emergencies. At Children’s Health, your child’s care team will provide you with a clear action plan. It spells out exactly when and how to give glucagon – at home, school or on the go. Knowing what to expect gives you confidence and helps everyone act quickly.

General steps for giving glucagon

• Keep the glucagon where everyone can find it quickly in an emergency.

• Make sure family members, caregivers, school staff and coaches know where the glucagon is and how to use it.

• If you haven’t already, check your child’s blood sugar right before giving glucagon.

• Follow the device instructions carefully. Different products have different steps.

• Call 911 right after giving glucagon.

• If your child doesn’t respond within 15 minutes, give them a second dose if that’s part of the care team’s action plan.

• Throw away leftover medicine or used devices after giving the dose.

Giving glucagon with a traditional injection kit

• Glucagon kits include a vial of powder and a syringe with liquid.

• Mix the liquid and powder only when you’re ready to use the dose.

• Draw the mixed solution into the syringe and inject it into the outer thigh or arm.

• Inject directly into the skin, not through clothing.

• Don’t use the solution if it looks cloudy, has particles or changes color.

• Discard the syringe and vial immediately after giving the dose. (Each kit is single-use.)

• Throw away needles in a hard container designed to hold used needles and syringes (sharps disposal box). Don’t reuse needles or other items.

Giving glucagon with a prefilled injector or syringe

• Prefilled injectors are already mixed and ready to use.

• Remove the cap and press the injector firmly against the outer thigh or arm, directly on the skin. Don’t inject through clothing.

• Dispose of the used injector right away in a sharps disposal container. (Each injector is single-use.)

Giving glucagon nasal spray

• Use nasal glucagon only in the nose. Keep the medicine away from your child’s eyes and mouth.

• Insert the nozzle into one nostril and press the plunger to release the full dose.

• Throw away the container immediately after giving the dose. (Each device is single-use).

After giving glucagon

• Lay your child on their side to prevent choking if they vomit.

• Check your child’s blood sugar again right after giving glucagon and 15 minutes later.

• When your child is awake and can swallow, first give them fast-acting carbohydrates. Options include juice, regular soda, frosting, or glucose tablets or gel.

• Follow with a snack with protein, fat and longer-acting carbohydrate. Good options include cheese or peanut butter with crackers, a single-serve container of yogurt, or half a sandwich and a small glass of milk.

• Be prepared for possible nausea or vomiting.

• Call your child’s care team to report the episode. We may need to adjust your child’s care plan for insulin, meals and physical activity.

• Replace your supply of glucagon as soon as possible.

How do I store glucagon?

Proper storage helps glucagon work when you need it. If you are unsure whether your glucagon has been stored correctly, bring it to your child’s appointment. The care team can check it for you and provide a replacement if needed.

All glucagon injection products:

• Store at room temperature. Don’t refrigerate or freeze any items.

• Keep in the outer carton to protect from light.

Prefilled syringes and auto-injectors:

• Store in the foil pouch until you’re ready to use.

Glucagon nasal spray:

• Store at room temperature.

• Keep in the shrink-wrapped tube until ready for use.

All products:

• Check expiration dates monthly and request refills before they expire.

• Keep all medicines in a safe place, out of the reach of children and pets.

• Throw away unused or expired medicines safely. Don’t flush or pour down the drain.

• Ask your pharmacist about drug take-back programs in your area for safe disposal.

How do I prepare my child for glucagon?

When everyone feels prepared, it’s easier to respond quickly and calmly. You can prepare by:

• Learning how to give glucagon and practicing with your child’s care team.

• Making sure your child, if they’re old enough, understands what glucagon is and when they might need it.

• Teaching babysitters, relatives and older siblings how and when to use glucagon.

• Sharing the action plan with school and after-school programs.

• Keeping glucagon within reach during sports, sleepovers and travel.

What are the Child Life services for glucagon?

Our Child Life team helps children and their siblings feel comfortable with all kinds of medical treatment. Our specialists use age-friendly teaching and play to explain procedures like using needles for glucagon and other diabetes care. Ask your care team for a referral.

What questions should I ask my provider about glucagon?

Here are important things to ask your child’s care team during appointments:

• Which form of glucagon do you recommend for my child’s age, activities and daily routines?

• When exactly should we use glucagon instead of juice, gel or glucose tablets?

• Can my child use mini-dose glucagon? What are the steps?

• How should we train our school nurse, teachers, coaches and other caregivers?

• How many devices should we keep at home, at school and for travel?

• What should we do after we give glucagon, and when should we call 911?

• Children’s Health: Glucagon handout for parents

• Endocrine Society: All About Glucagon

• National Institutes of Health (NIH), National Library of Medicine, MedlinePlus: Glucagon Injection

• NIH, National Library of Medicine, MedlinePlus: Glucagon Nasal Powder