The Gvoke HypoPen autoinjector is now available in the US. I hope Xeris will launch it in Europe soon as well. This would be such a major improvement over the current cumbersome glucagon kits. I never bothered to explain how they work to anyone except my parents. An easy to use autoinjector might change that.
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I’m hoping this comes to Canada soon, too.
We have the Lilly glucagon nasal spray here, which is also a good choice for emergencies, and tiny to carry around (about the size of a vial of strips).
However, I love the idea of the Gvoke pre-filled syringe for micro-dosing.
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Curious how you would micro dose with it?
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I haven’t seen the syringe, since it’s not available in Canada. But I imagine the plunger can be pulled out and the glucagon drawn into a regular insulin syringe.
If you’re asking about micro-dosing glucagon in general, that can be useful for prolonged lows, situations where you can’t eat (for example, I have a condition called eosinophilic esophagitis that can cause my esophagus to swell completely shut, and have had a situation where I had insulin on board but could not eat or drink), situations where you’re throwing up but need insulin to treat ketones, and so on. I don’t think it’s recommended very often in the USA, but it’s been recommended here in Canada since I was a kid.
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Thanks, I was thinking maybe it allowed you to choose a dose amount. Looking at it closer it looks like it is single use item unless like you said, there’s a way to get at the vial.
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The autoinjector is definitely single-use. I don’t think you could take it apart without accidentally activating it. But the same company also makes a pre-filled syringe, that I imagine is like any other syringe, and has a plunger that can fairly easily be removed. (But I haven’t seen it, so maybe I am wrong.)
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That’s right, they make both these products. I don’t know if the plunger from the pre-filled syringe can be removed, but I think it’s possible to inject the glucagon into a vial.
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I thought Xeris initially had plans to develop a multi-dose glucagon pen as well. On their technology page, they mention that their products can be packaged in various ways including multi-dose pens, but they don’t explicitly state that their glucagon will be made available as a multi-dose pen. Currently, their pipeline shows they’re developing self-administered glucagon for treatment of Post-Bariatric Hypoglycemia and Exercise-Induced Hypoglycemia. I wonder if these will come as multi-dose pens that we as patients can repurpose for any kind of hypoglycemia.
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Just to chime in here, with nothing of much significance, I found it interesting that the company defined a “sever low” as a BG lower than 50. Even if I am in my 30s I take a little juice. I don’t go right for my Glucogon injection.
Anyone else find this to be true?
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Most definitely…any 30’s, 40’s or 50’s we would never consider Glucagon…simple skittles, juice, etc., work just fine. Maybe if Liam were 30’s AND sleeping/not waking up, then most certainly, yes. If he’s awake, he’s always able to eat/drink something, sit down and wait 15 min then vwala! Hell, even when he’s sleeping he can still chew up smarties - if he were sleeping, I would probably try feeding him Smarties before giving this medicine. In the going on 5 years Liam has had Diabetes, I’ve only used Glucagon one time.
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I never go for my glucagon kit, because I don’t want to waste it on a non-emergency situation. However, I would like to have something like a small-dose pen for lows < 2 mmol/l (36 mg/dl), because those are quite unpleasant and I wouldn’t like to pass out with no one around. And at night, when I wake up with a low, it would be so convenient if I could just give a small shot of glucagon and then continue sleeping.
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Same here!
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In 30+ years, I have never used the Glucagon once. And I’ve gone down to a BG of 15 once but corrected with LOTS of juice. was back in range within 15 minutes. (but I would never do that again 
, it wasn’t a smart decision and it was very uncomfortable. I’m surprised I didn’t die.)
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For me, it would probably depend if I had any IOB. If I was at 30 with 5u on board. I probably be running for the glucagon.
Having said that I’ve never used it in 39 years…Yay.
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This would be ideal. I would actually prefer just to take a few units of glucagon to treat an overnight low than have to get up and eat something. 
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I’ve never used glucagon for a severe low in coming up on 29 years. But I did have lows when younger that were pretty borderline, or where I did pass out and glucagon probably should have been used. I have not had severe lows like that since getting off NPH insulin.
As an adult, I doubt I would ever use the full dose of glucagon while conscious. Which is why it’s important there’s a method, like the autoinjector or nasal spray, that is super easy for family, friends, or bystanders to use. Since I wouldn’t be using it, it doesn’t matter if I know how to use it, it only matters if others can be easily trained and remember how to use it when the time comes (hopefully never).
I have, as an adult, used micro doses of glucagon for lows that would not come up on their own (like overnight lows where I’m stuck at 2.8 mmol/L for six hours straight regardless of what I eat or drink). I’ve also had situations where I’ve been dropping low, had insulin on board, and been unable to eat or drink due to other medical issues.
So I definitely think an easy-to-use emergency glucagon (autoinjector or nasal spray) and a convenient way to micro-dose glucagon (such as a pen) would both be great additions to my diabetes toolbox.
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I completely agree. I would sprint, though 
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This is a discussion I have had with Eric before as (as I already stated) I have never used the Glucogon. I went to my CDE with my husband so that we could both learn how to use it, especially bc the instructions are so minuscule and seemingly endless, and I would most likely die while he was trying to read them. One thing that Eric explained to me, which my CDE did not mention, was that if you were to take the entire syringe of the Glucogon, you would most likely spike over 300 BG. I would not like to b on that roller coaster. So the idea that there is an option that allows for micro-dosing is very appealing to me as well.
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Well, the part I left out is that I wouldn’t have a problem with someone using it on my if I were unconscious. A blood sugar of 300 mg/dl is better than being dead. So I would like an easy-to-use emergency option for other people to use on me if the need ever arose. And then I would like a micro-dose option that I could use myself to deal with less severe lows.
It’s funny, because micro-dosing has been something I’ve known about since I was a kid in the 1990s. The only disadvantage of it is that, with the current kits, it expires in a day or two once mixed. It seems many in the USA, many have never heard of micro-dosing as an option, and some even act like it’s crazy that you’d ever want to inject glucagon for a non-emergency low.
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