The Food and Drug Administration (FDA) recently approved inhaled glucagon — a medication used to treat severe hypoglycemia in patients with diabetes. For decades, people suffering from severe hypoglycemia had to be treated with a rather cumbersome glucagon injection. But with the approval of inhaled glucagon, these individuals will now have a choice to inhale or inject their medication.
What is Severe Hypoglycemia?
Severe hypoglycemia typically occurs in people with diabetes who are using insulin to manage their blood glucose, or blood sugar, levels. Severe hypoglycemia occurs when blood sugar levels fall below 54 mg/dl, which causes you to become confused, unconscious, or suffer from other symptoms that require assistance from another person for recovery.
What is Glucagon?
Glucagon is a hormone produced in the pancreas. Glucagon is used to raise very low blood sugar by stimulating the release of stored glucose from the liver.
The American Diabetes Association (ADA) Standards of Care recommend that glucagon be prescribed for all individuals at risk for severe hypoglycemia. Glucagon is usually given by injection beneath the skin, in the muscle or the vein.
What is Glucagon Nasal Powder?
Until recently, the only way to administer glucagon was an injection that had to be mixed in a several-step process. However, with the FDA approval of Baqsimi nasal powder, glucagon can now be inhaled. Baqsimi nasal powder is the first glucagon therapy approved for the emergency treatment of severe hypoglycemia that can be administered without an injection
Baqsimi, which is a powder administered into the nose, comes in a single-use dispenser that can be given to someone suffering from a severe hypoglycemic episode. Baqsimi increases blood sugar levels in the body by stimulating the liver to release stored glucose into the bloodstream. It has the opposite effect of insulin, which lowers blood sugar levels.
The safety of Baqsimi nasal powder was evaluated in two studies comparing a single dose of Baqsimi to a single dose of glucagon injection. Baqsimi adequately increased blood sugar levels. In a pediatric study of patients over the age of four with type 1 diabetes, similar results were observed.
Baqsimi should not be taken by patients with pheochromocytoma, a rare tumor of adrenal gland tissue, or by patients who have insulinoma, a tumor of the pancreas.
The most common adverse reactions associated with Baqsimi are nausea, vomiting, headache, upper respiratory tract irritation, watery eyes, redness of eyes, and itchiness. Side effects of Baqsimi are similar to injectable glucagon, with the addition of nasal and eye-related symptoms, such as watery eyes and nasal congestion, because of the way the drug is administered.
Who Should Use Glucagon?
According to the ADA, glucagon should be prescribed for all individuals at increased risk of severe hypoglycemia, so it is available should it be needed. Talk to your health care provider about when and how to use glucagon. Glucagon administration is not limited to health care professionals. If you are likely to have severe hypoglycemia, you should teach your family, friends, and coworkers when and how to give you glucagon.
Constance Brown-Riggs, is a registered dietitian, certified diabetes educator, national speaker and author of the Diabetes Guide to Enjoying Foods of the World, a convenient guide to help people with diabetes enjoy all the flavors of the world while still following a healthy meal plan. Follow Constance on social media @eatingsoulfully
