I went out for dinner and seriously overestimated carbs when bolusing, so kept treating and crashing for over an hour. Back home, injected 0.5 mg glucagon, subcutaneous, around 11 p.m. BG quickly went up to about 6 (110) and hung around there, but then at 2 a.m. I had a rapid rise up to 14/15 (250/270). Three hours is too late for an overtreatment spike, and nothing I’ve read says a delayed spike is normal after glucagon. Injected double my correction dose but it wasn’t that effective. Is this normal, or a weird one-off?
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I have not used glucagon microdosing, but do have a comment. In terms of “units” in an insulin syringe, you gave 50u glucagon. The recommendation I saw was 15u to start, and if that wasn’t enough, after 30 minutes try another 30u. http://www.bcchildrens.ca/endocrinology-diabetes-site/documents/minigluc.pdf
I wonder if your dose may have not been fully absorbed initially, and the remainder caused that delayed spike. Was your injection site one that possibly had been overused for insulin dosing in the past?
I hope someone with actual experience microdosing glucagon has some insight.
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That has not happened to me.
Did you eat a lot of carbs during your crashing low time? Because if you did, it might just be the normal result of having a lot of carbs in your system.
After big dinner nights, I always need a lot more basal during the night.
And as @bkh pointed out, 0.5 mg of glucagon is not really a micro-dose. For me, that’s a shoot-me-to-the-moon dose.
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I didn’t know how to convert, and wasn’t in a state to start googling. But given my result from 50U, an initial 15 wouldn’t have done anything. Also, I realized my glucagon was a year beyond its expiry date, which Eric has found doesn’t really matter, and apparently is fine if you’re not using it for coma emergencies. I’ve never used glucagon in 50+ years of diabetes, so to even have it in the house is unusual.
That is possible. I used my thigh, because it was easiest at the time, and childhood lipoatrophy never fully recovered. I occasionally inject insulin there and it appears to absorb OK, but pods have a hard time there.
No more than usual, and all ones I have a quick response to (apple juice, sugar syrup, hard candy), not three hours later. Nor was dinner large or high-fat, just an ordinary weeknight dinner with old friends. (OK, I had a slice of my chocolate cake with mocha walnut frosting, but over the previous week I’d eaten half my trial run and never had that spike.)
Anyway, I didn’t know if that was a normal delayed result and if so, in future I could counteract it with a bolus, but it doesn’t sound like that’s the case.
Thanks, both, for your insights.
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We can can be so different, But I can tell you my body likes to give a delayed response to carbs sometimes. And that especially happens with higher protein digestion. High protein, low carbs, big delay and I have to watch for the spike from the protein that comes at some point hours later. Very high protein and very high carbs, same problem. A huge delay in response, many hours later. Our bodies don’t work right so many things can play a part.
The first tells you all the things in a type 1 that might not work right. The second article doesn’t explain anything specifically for you, but I found it quite interesting.
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What glucagon product? The only options I saw were single dose and remarkably expensive.
I used the standard 1 mg powder/liquid kit. You don’t have to use all of what you mix up in the vial.
The price was always a disincentive for me through the decades I didn’t have insurance. When my spouse’s work plan suddenly covered 100% of everything except underwear, I stocked up. Which is why what I used was expired, and now, I’ve discovered, discontinued.
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There is a generic of that same thing though. You can still get it!
It comes in the exact same red plastic kit that came with the Lilly kit. It has the same powder and same mixing solution in a syringe. Absolutely identical, except it is made by a different company.
I can post a picture and find my prescription info if you want it.
I also have a bunch of them, so I can send you some if you want.
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Thank you, Eric – very generous of you. It’s on reorder at my pharmacy so they’ll give me whatever the approved replacement is. I have some Baqsimi on hand as well, though I’m not sure if low-dosing is possible.
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