I keep glucagon around mostly in case I want to mini dose it. Which I’ve never done as of yet.
Long story short, I was fiddling with a glucagon kit and a 30 unit syringe, and I discovered the syringe lies nicely beside the larger syringe and the case closed no problem. So I think I’ll krep the small syringe in the kit.
A rolled- or folded-up alcohol swab also fits perfectly on the opposite side.
So now you’ve got a mini dose or full dose kit in one. (However, if I was expecting others to use these kits I wouldn’t put all this extra stuff in it, lest it confuse them in the moment of need.)
That is super smart! I have one in my backpack for our upcoming backpacking trip, which starts Monday, and I’m going to fit that thing out with a spare syringe and wipe. I don’t know how comfortable I would feel doing mini dosing with it, while on the trail, but I’ll read up and see if I can better understand your suggested use case.
Glad you found a cool hack for the case! @Eric would probably approve!
I like the hack for the case. That is a good idea, having a syringe in there.
But I would suggest that when you are in the wilderness and hiking, mini-dosing is not a good idea. You need to replenish liver glycogen with carbs when you are hiking instead of using it up with glucagon.
Mini-dosing is a great idea, as long as you replenish the carbs (i.e. refill the liver’s storage). But when you are doing a lot of activity, such as hiking, it is best to take in more carbs.
Yeah, the one scary thing about glucagon is that my understanding is you can use it once and then it won’t work (nor will you have any protection against lows) for the next day or two.
I bring glucagon with me travelling, but I only go on trips that involve hotels.
I wonder how this sort of thing is working out in the trials they’re doing of the glucagon pen designed specifically for mini-dosing. Based on my reading, I think a mini dose for an adult would be about 10-15 units (don’t quote me). But maybe if you’re only giving one or two units throughout the day to prevent lows, it wouldn’t use up all the stored glycogen.
The liver holds about ~100 grams of glycogen for everyone, regardless of their size (I think the actual range is said to be 90-110 grams). The 300-400 gram range is for muscle glycogen, which does vary based on size and training.
@Eric
To make sure I am not still confused - at least on this.
lol
So glycogen and glucose are not the same thing. However 1 g of glycogen is able to produce (or be converted into) 1 g of glucose (or darn close). Is this proper or am I confusing these?
Doing 25 units, I got anywhere from 50-100 points out of it. It depends on how much your liver has available.
Your liver has about 100 grams of storage when full. But when depleted, you get much less from it.
I have actually done glucagon while running, after going 10-12 miles, to see what would happen. I took an entire dose one time, the full 100 units, and got absolutely nothing from it. No rise at all. My liver just said - sorry, don’t have any to spare now…
So what you get from it will depend greatly on how much glycogen is in your liver at the time. But in normal conditions, like not when almost completely depleted, you can figure it has about 100 grams.
I saw at most a 100 point rise from 25 units of glucagon, when my liver was full. So in normal conditions, 10-15 units of glucagon will give you a comparable amount, probably about 40-60 points rise (sorry, that;s mg/dL units )
Since people have the same liver glycogen storage, I think that would be fairly consistent for most people.
Mini-dosing is useful, as long as you don’t do it too much and deplete your liver and not replenish it. I think the potential problem when they put glucagon in pumps is if people keep using it and never eat. Eventually the liver would run out, and then the person would be in trouble. I think you could get by with a couple of mini-doses, but I don’t think it would be good to push it beyond that.
Glycogen is simply a combined chain of glucose molecules. A bunch of glucose stored together.
The grams used when speaking about glycogen and glucose are interchangeable in terms of how much energy they provide.
1 gram of glucose or glycogen provides 4 calories of energy.
The term “Calorie” people refer to in food (upper case C), is actually a kilocalorie. One kilocalorie is the same as one Calorie.
Keeping it super simple, you can convert stored glycogen to glucose grams directly, 1-to-1.
And you can convert grams of glucose to calories by multiplying by 4 (1 gram of glucose provides 4 calories of energy).
The only potentially confusing thing is that by weight, glycogen has water stored with it. Since glycogen is hydrated at about a 3 to 4 part ratio, the weight is not equal. So if you use up all 100 grams of liver glycogen, you would lose 400-500 grams of weight.
Sorry, does this answer your question or is it too much blah, blah?
Very simple answer is, for what we are speaking of, yes 1 gram of glycogen is the same as 1 gram of glucose from what you can “get out of it”.
We are going carb heavy as an homage to you @Eric. I’ve got the glucagon “just in case” and otherwise plan to use the 2lbs of sugary crap I’ve forced my mother to bag up into individual portions to keep the BG in range (hahahah or aim for that).
Good point about using up the glycogen stores though. This exercise will probably qualify as strenuous at certain points. Heavy packs and lots of walking (well, heavy compared to the running ones you’re used to!).
You could pop open the vial that contains the powder, put it on a glass surface and cut it into somewhat equal amounts. Since it is just a subcutaneous injection, sterility is not as crucial as it would be for an intravenous injection. That would let you use it over a very long time instead of just 5 days. It is the mixing with the diluent that starts the countdown clock of its usefulness.
I got 5 days out of a mixed glucagon after it was mixed. After mixing it, it does not last too long. So the trick is to separate the powder and only mix what you need. Otherwise you are limited by time.
You can’t use straight saline to dilute it. The diluent contains water, glycerin, and hydrochloric acid.
You mix it up using the sterile water in the big syringe as uaual. Then you use the small syringe to draw up however many units you want (you can find guidelines about how many units to use on several hospital sites).
So you’d only be able to use the kit for either the full dose once, or mini dosing within 24 hours or so.
Would you consider dividing the powder like I mentioned above and doing it that way? I think if you had a good scale, you could divide it into equal parts - like maybe fifths or fourths. That way you could use it over a longer time.
As far as where to keep the powder once you divided it, I think an unused (and well-labeled) insulin syringe would be a good place to store it. And you could just pull a corresponding amount of diluent out of the original vial to use.
I think I may talk myself into trying to split the powder.
The problem for me is - given the choice between eating and injecting glucagon - I would always take food. The only time I do the glucagon is for experimentation, or when I am zonked out and my wife gives it to me.
Doughnut or 20 units of glucagon? Not a hard choice for me.
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