A Glucagon Emergency Kit is a rescue injection kit containing the hormone glucagon used to treat severe hypoglycemia (dangerously low blood sugar), typically in people with diabetes who take insulin. Glucagon is a natural hormone (normally made by the pancreas) that raises blood sugar levels by causing the liver to release stored glucose. In an emergency, when a person’s blood sugar has dropped so low that they lose consciousness or cannot safely eat or drink, this kit provides an immediate way to bring their blood sugar back up. It is a prescription medication and a critical part of emergency planning for anyone with insulin-dependent diabetes, meant to be used by caregivers or bystanders on the person’s behalf.
When and Why to Use a Glucagon Kit
This kit is intended for cases of severe hypoglycemia, which means blood sugar levels have fallen to a point that the person may become confused, have a seizure, pass out, or be otherwise unable to self-treat with oral sugar. Common scenarios include an insulin overdose, missing a meal after insulin, intense exercise without adjusting food/insulin, or illness – all can trigger a sudden drop in blood glucose. If the person is unconscious or too disoriented to swallow, giving sugar by mouth (like juice or candy) isn’t possible or safe, and that’s when glucagon is needed. Glucagon injection quickly elevates the blood glucose by prompting the liver to dump stored sugar into the bloodstream. It essentially buys time and can be life-saving, reversing severe hypoglycemia within minutes, while you also call for medical help (severe low blood sugar is a medical emergency).
It’s important that family members, friends, or coworkers of someone at risk for severe hypoglycemia know where the glucagon kit is kept and how to use it in an emergency. Doctors often instruct that “if the person is unable to swallow safely or is unconscious from low blood sugar, do not try to force food or liquid – instead administer glucagon and call 911.” Many people with type 1 diabetes, and some with type 2 diabetes on insulin, have a glucagon emergency kit at home, work, or school for this reason. Glucagon injection typically works within 5 to 15 minutes, so the person usually regains consciousness as their blood sugar rises. (If they don’t improve in about 15 minutes, a second dose can be given if another kit is available, while waiting for emergency services.
Aside from treating insulin-related hypoglycemia, glucagon is occasionally used in medical settings as a diagnostic aid during imaging tests of the stomach or intestines. In that context, a dose of glucagon can relax the digestive tract muscles to improve visibility during an X-ray or scan. However, the term “Glucagon Emergency Kit” usually refers specifically to the rescue kit for low blood sugar in diabetes.
A Glucagon Emergency Kit is a life-saving treatment for severe low blood sugar. It contains a dose of glucagon (a hormone that rapidly raises blood glucose) in a vial that must be mixed with a provided liquid and then injected into muscle or under the skin. It’s used when a person with diabetes has a very low blood sugar and is unable to eat or drink – often when they are unconscious or having a seizure. Loved ones should be familiar with the kit’s mix-and-inject process so they can act quickly in an emergency. After giving glucagon, the person should wake up in minutes as their blood sugar rises; you should then follow up with oral carbohydrates when they can swallow and get medical help. Common side effects like nausea and vomiting can occur, so position the person on their side. This rescue therapy has been a cornerstone of diabetes emergency care for decades, and newer user-friendly versions (auto-injectors and nasal powder) are now complementing these kits. Having a glucagon emergency kit on hand – and knowing how to use it – is critically important for anyone at risk of insulin-induced severe hypoglycemia.
How Glucagon Works
Glucagon is essentially the hormonal opposite of insulin. Insulin’s job is to lower blood sugar (by moving glucose into cells), whereas glucagon signals the body to increase blood sugar. When injected, glucagon travels through the bloodstream to the liver, where it binds to glucagon receptors and triggers a process called glycogenolysis – this means the liver breaks down stored glycogen (a form of stored glucose) and releases glucose into the blood. This surge of glucose from the liver raises the person’s blood sugar level, hopefully out of the danger zone. Glucagon can also stimulate a process called gluconeogenesis (making new glucose from other molecules) in the liver, but this is a slower mechanism; the immediate action is mostly from dumping existing glycogen stores.
It’s important to note that glucagon’s effectiveness depends on the liver having some stored glucose available. In most cases of insulin-induced hypoglycemia, there is enough glycogen in the liver to respond. However, if someone has been fasting or drinking large amounts of alcohol, or has adrenal insufficiency, the liver’s reserves might be low; in such cases glucagon may be less effective, and intravenous glucose from paramedics would be needed. For the typical scenario of an insulin reaction, though, glucagon works quite well. After glucagon is administered and the person’s blood sugar rises, the hormone’s effect wears off in a short time (generally 1–2 hours or less, as the glycogen stores deplete or if another meal isn’t eaten). That’s why following up with food is critical to sustain the recovery.
Besides raising blood sugar, glucagon has some other effects. One notable effect is that it relaxes smooth muscles of the gastrointestinal tract. This is normally not very noticeable to the person when glucagon is given for hypoglycemia (they’re more preoccupied with waking up and the nausea perhaps), but it’s precisely this effect that doctors leverage during certain medical tests – for example, during an endoscopy or radiology procedure, an injection of glucagon can temporarily halt intestinal movement This allows clearer imaging of the stomach or intestines. In the emergency kit context, the GI relaxation isn’t the goal, but you might observe that after waking up, the person’s stomach may feel temporarily slow or they might have some abdominal discomfort (usually overshadowed by the nausea).
What’s Inside the Glucagon Emergency Kit
Most glucagon emergency kits come as a small case or box containing two primary components: a vial of powdered glucagon and a syringe pre-filled with a sterile liquid (diluting solution). The powder is glucagon (1 mg) in a stable, freeze-dried form, often with a tiny amount of lactose or other inert ingredients. The syringe contains Sterile Water for Injection (1 mL) – this liquid has no medication in it, it’s just the vehicle for dissolving the glucagon. These kits are kept in this form because glucagon is not stable in liquid form for long periods, so it has to be mixed right before use.
Using the kit involves a few quick steps:
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Mixing the solution: Remove the caps from the vial and the syringe. Inject the entire liquid from the syringe into the vial of glucagon powder. Gently swirl or roll the vial until the powder dissolves completely and the solution is clear. (Do not shake vigorously, as that can cause foaming.) Now you have a syringe full of ready-to-use glucagon solution.
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Drawing up the dose: Make sure the syringe needle is still in the vial. After the powder is dissolved, draw the liquid back into the syringe. The kit is designed such that the full contents of the vial (when mixed with the diluent) equal a standard adult dose of 1 mg of glucagon. For adults and children over ~44 lb (20 kg), the entire syringe (1 mg) is usually given. For small children under ~44 lb, half the dose (0.5 mg) is often given – in that case, you would draw up only half the vial (your doctor or the kit instructions will clarify the pediatric dose).
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Injecting the glucagon: Glucagon can be injected intramuscularly (into muscle) or subcutaneously (under the skin). In an emergency, the recommended injection sites are similar to those for an epinephrine pen – the outer middle of the thigh is a common choice (muscle here is a large target). It can also be injected into the upper arm (deltoid muscle) or the buttocks. The injection technique is like any typical shot: cleanse the skin if possible, insert the needle at a right angle into the muscle or skin, and push the plunger to deliver the medication. Glucagon doesn’t necessarily need to be injected by a healthcare professional; in fact, it’s designed so that trained family or friends can administer it during a severe low blood sugar emergency. There is no significant danger of “overdosing” with glucagon in this context– the main goal is to get the full dose in to help raise the blood sugar quickly. (Of course, always use it exactly as instructed. The 1 mg dose is standard; using more isn’t necessary or helpful, and using less than directed might not fully treat the hypoglycemia.)
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After injection care: Once glucagon is given, call emergency medical services (911) if not already called, and turn the person on their side to prevent choking. This is important because glucagon often causes nausea or vomiting as it works and if the person vomits while unconscious, being on their side helps keep their airway clear. As the person regains consciousness (usually within about 15 minutes), they may be groggy and feel nauseated. As soon as they are awake enough to swallow safely, give them a fast-acting source of sugar (such as fruit juice, regular soda, or glucose gel) followed by a longer-acting carbohydrate snack (such as crackers with cheese or a sandwich). The initial sugar boosts blood glucose immediately, and the follow-up snack helps prevent the blood sugar from crashing again – glucagon’s effect is short-lived and the person’s own insulin (if overactive or dosed high) could still cause the blood sugar to drop later if not countered with food. Even if the person feels completely better after glucagon, it’s recommended they inform their doctor about the severe low and be evaluated, in case adjustments to their insulin or treatment plan are needed to prevent future episodes.
Glucagon Side Effects
The most common side effects of glucagon injection are nausea and vomiting. This happens in a significant number of patients because of the way glucagon affects the gut and perhaps the sudden shift in blood glucose. It’s also why, as mentioned, we place unconscious patients on their side – to protect their airway in case of vomiting. Other possible side effects include a headache or dizziness (sometimes as part of the recovery from the hypoglycemia itself), a fast heartbeat for a short time, or injection site reactions (pain, swelling, or rash at the injection spot). Serious allergic reactions to glucagon are very rare, but since glucagon used to be made from animal sources in the past, older formulations carried a slight risk of allergic response. Modern glucagon (including in emergency kits) is made via recombinant DNA technology (it’s biosynthetic and identical to human glucagon), so allergies are exceedingly uncommon. Still, one should not use it if they are known to be allergic to glucagon or any component of the kit.
Glucagon is not effective for all types of hypoglycemia. For example, if someone’s low blood sugar is caused by excess alcohol consumption, glucagon might not work well because alcohol blocks the liver from releasing glucose. Also, in rare tumors like an insulinoma (a tumor producing insulin) or conditions like pheochromocytoma (an adrenal tumor), glucagon is contraindicated or must be used with caution, because it can have unpredictable effects (in pheochromocytoma, glucagon can trigger a surge of adrenaline release; in insulinoma, it might cause the tumor to release even more insulin after a transient rise in glucose). These are specialized concerns – for the general diabetic patient with insulin-related hypoglycemia, glucagon is very safe and appropriate. If there’s ever any doubt, use the kit in a true emergency, because untreated severe hypoglycemia is immediately life-threatening, whereas giving glucagon in a confusing situation will usually do far more good than harm.
After using a glucagon emergency kit, always seek medical follow-up. If 911 was called, paramedics will evaluate the person. If the person was treated at home and seems fine afterward, their doctor should still be informed that a severe episode occurred. Often, a severe low might prompt adjustments in medication doses or routines to prevent it happening again.
Glucagon Storage
Storage: Keep the glucagon kit at room temperature (avoid extreme heat or cold) and pay attention to the expiration date. Glucagon kits typically have a shelf-life of 1–2 years. If a kit expires, replace it – an expired glucagon may not work effectively. Do not mix the glucagon with the diluting solution until you need to use it; once mixed, it should be used immediately (it’s not meant to be pre-mixed and stored). If you ever mix a kit and don’t end up using it (say the person regains consciousness from eating something before you inject), that mixed solution should be discarded – do not put it back in the vial for later use.
Newer Forms of Glucagon (Beyond the Traditional Kit)
For many years, the mix-it-yourself kit was the only way to administer glucagon in an emergency. In recent times, newer products have been developed to make glucagon administration easier. For instance, there are now pre-filled glucagon syringes and auto-injector pens (such as the Gvoke® HypoPen and others) that don’t require manual mixing – you just push a button to deliver the dose. There’s also a nasal glucagon powder (brand name Baqsimi®) that can be sprayed into an unconscious person’s nose, where it’s absorbed and works similarly to the injection. These innovations are improving ease of use, especially for caregivers who might be intimidated by the old kit. However, the traditional Glucagon Emergency Kit (with vial and syringe) is still widely used and available, often as a lower-cost option and a reliable standby. Regardless of format, all glucagon rescue treatments serve the same purpose: to swiftly raise blood sugar and save someone’s life in a hypoglycemic emergency.
