FUDiabetes

[FIRSTS] - Used Glucagon tonight (09012019)

After 3.5 years I used a little tonight on Liam. He has been sick and we thought he was better but his BG management has been insane for the past few days. Tonight he started projectile vomiting again and bgs we’re headed down into the low 60s. Because he refused to eat or drink anything I wasn’t about to have another night of 40s and 50s for hours on end so I did it… Mixed it and gave him about a quarter or less of the liquid mix. He’s sleeping now and his bgs are in the 70s.

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I am sorry he is sick. :frowning_face:

It’s extremely useful to track what you see from glucagon, for future reference. You really can get granular with it for your particular dosing needs.

I get about 20 points per 5 units. And you can do it multiple times if you need to. Try a small amount, and if you need to, you can add some more a little bit later.

I think the shelf-stable stuff would be a huge development. Bigger than anything that has come out in the past 10 years. Imagine not having to wake him up at night for a drink or snack, you could just pop a few units into him if he is low.

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With my adult relative test subject, we got similar.
75 points with 15 units in about 20 minutes.

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Also, keep in mind that the liver only stores about 100 grams worth of carbs. So after X units of glucagon, his liver will be done with responding to glucagon until he eats again!

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Starting rising immediately.

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I wish I could say I measured it but I didn’t. I only mixed it and drew out just a bit… Whatever that equates too.

Use an insulin syringe instead of the syringe it comes with. That way you can do precise measuring.

Obviously that’s not the way to go in an emergency situation. But in a non-emergency, it’s very helpful.

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If he needs more I’ll make sure to use one.

You could draw out a similar amount of water and eyeball it to make it close. Probably it would be pretty close.

Then shoot the water into a shot glass and use a regular syringe to draw it up and measure.

Should give you a pretty good idea.

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I want to repeat it because it is very important - you have a 100 gram bank account.

If he is not eating, keep an eye on that account balance!

Calculate what you are taking out of it with the glucagon. Once it is gone, there is nothing in there until he eats again.

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poor Liam. Stomach bugs are the worst. I’m glad you were able to get his BG up. When they’re vomiting it really is easier to give them mini-glucagon and let them get some rest. You know to use 1 unit per year of age, right, so for him about 5 or 6 units?

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It’s really much faster than glucose tabs I find! like within 10 minutes you can see it kick in and it’s very sharp. Whereas at night, for us, low treatments take a long time to register on CGM.

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Thanks. I actually didn’t know that. All I knew was that a little was better than juice or candies since they are automatic and won’t be thrown up. I’ll take a look at the syringe tomorrow to estimate how much he had. He keeps waking up and either dry heaving or throwing up small amounts. Will be looking forward to this time passing.

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poor little one. Hope he recovers quickly. Have you checked his ketones? When they’re vomiting but not eating and Loop may be suspending lots of basal is a really good time to check.

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I am guessing you don’t have any 100 unit (1 ml) insulin syringes but might have some 30 unit insulin syringes?

The glucagon kit has about 100 units, or 1 ml.

So if you withdraw all of the remainder into whatever insulin syringes you have available, you can subtract the difference from a 100 unit starting point and calculate what you gave him.

Like for example, if you can get 65 units from the vial now into a few insulin syringes, you know you gave 35 units.

For very simple things like this, and to make it very easy for the future, I think having a set of 100 unit syringes can be very useful. I use them for loading pods, for mixing diluted insulin, for all kinds of stuff. Very cheap and makes stuff like this easy.

Like if I want to dilute insulin to 15%, it’s so easy with a 100 unit syringe. 85 units diluent, 15 units insulin, and I am done.

$5 for a pack of 25 syringes.

EDIT
Just to clarify this - if the glucagon is still in the syringe that came with the kit, inject it back into the vial and withdraw it with your insulin syringes for a precise measurement.

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It looks like I gave him around 10 units.

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About how many carbs is each unit of glucagon worth?

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There is some variability for each person.



Side notes, not directly to your question:

The liver stores about the same for each person. Around 90-120 grams worth, depending on a person’s size. But generally about 100 grams.

But if your liver is not completely full - like after a day of vomiting and not eating - you would see less from a unit of glucagon than you would after normal eating.

I have tried it in a depleted stated, and I saw a lot less of a rise from the same amount of glucagon than I did on a day of being fully restocked after a big meal.



But anyway, back to your specific question…

For me, if I have a full store of liver glycogen, I get about a 20 point rise for 5 units of glucagon.

But I don’t really equate it to an amount of carbs. Like if my BG is 50, I wouldn’t say that I want “X number of carbs”. I would say I want to rise 30 points.

So the equation of glucagon to carbs is a bit more rough for me to calculate than glucagon to BG points. And there is variability for each person.

But my personal rough estimate based on many times of using it might be that for me it is maybe about the same as 1-2 grams of rapid carbs per unit of glucagon.

Like a 25 unit glucagon shot is about like a 50 gram sugar soda, or something like that. Not slow carbs, very rapid carbs! Like all of it right away!

But a) it is different for Liam, and b) sorry, I am not much of a carb-counter!
:man_shrugging:

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@ClaudnDaye, I sure hope Liam turns a corner on this soon. That is no fun for anyone. Sending you all a big hug.

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Well, he slept well and the glucagon definitely did the trick.

10 units the first injection and 5 each of the other three times.

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