Emergency Glucagon for Type 2 Diabetes: “My blood sugar was 37 mg/dL…”
Maria Ramirez was diagnosed with type 2 diabetes at 15 years old. Misdiagnosed with type 1 at first, many of her family members lived with type 2—and her doctors determined that her genetics set her up for an early diagnosis.
“I was hospitalized for five days, my blood sugar was 20.5 mmol/L369 mg/dL,” recalls Ramirez. “They did a lot of testing to make sure it was type 2. They told me that my body makes enough insulin, but that my body just doesn’t respond to it normally.”
Today, Ramirez is 30 years old, managing her diabetes with Humalog (rapid-acting) for mealtime insulin, and Tresiba (long-acting) for background insulin.
“I’ve definitely had low blood sugars,” says Ramirez. Despite being on insulin, her healthcare team hasn’t prescribed her emergency glucagon since she was diagnosed.
“I had that older glucagon kit when I was 15, but I never had to use it,” she recalls. “I’ve seen paramedics use it once on my grandfather, who has diabetes.”
What is emergency glucagon?
Anyone who takes insulin should also have a prescription for emergency glucagon—and keep that glucagon product in an easy-to-reach place in your home or with you.
Don’t forget to teach friends and family members about how to use emergency glucagon on you if you’re not able to treat your own low blood sugar.
Once it gets into your system, it raises the blood sugar by sending a signal to the muscles and liver (where glucose is stored in your body). The effect of glucagon is opposite of the effect of insulin, raising blood sugar instead of lowering it. It comes in several forms including a nasal spray, auto-injectors, pre-filled syringes, or a powder that must be mixed with a liquid before injecting.
Emergency glucagon treatment can raise your blood sugar during severe low blood sugars (hypoglycemia). It’s a hormone that tells your liver to release its stored sugar (also known as glycogen) into your bloodstream.
Friends and family members can treat you with emergency glucagon if you are unable to eat, swallow, unconscious, or seizing during a severe low.
My experience with very low blood sugars…
Ramirez has experienced her share of severe low blood sugars, but so far, she’s never lost consciousness.
“I have one or two lows a week,” she says. “I get really shaky, clammy and sweaty when I go low. And my brain tells me to just eat, eat, eat.”
Ramirez makes an effort to treat her lows with the recommended 15 grams of fast-acting carbohydrates—using juice or jelly beans—but the cravings that come with low blood sugars can make that challenging sometimes.
“I had a 2.0 mmol/L37 mg/dL in the middle of the night,” recalls Ramirez. “I don’t know how I was even able to get up, but I had to go upstairs to where I keep the juice boxes. I don’t even know how I was able to open the juice!”
If Ramirez had been unable to walk upstairs, her husband would’ve needed an emergency glucagon treatment to help her with this intense low blood sugar before also calling 911.
She remembers drinking it quickly, going back downstairs to bed and falling back asleep quickly.
“I woke up at 3 a.m. and checked my blood sugar again. I was 6.9 mmol/L125 mg/dL,” says Ramirez, who felt so drained by the intense low blood sugar she slept until 10 a.m. the next morning.
Working bit by bit on my diabetes goals
“I’m trying to be more conscious of my carbs right now, eating smaller portions, eating more slowly and I’m exercising, too,” says Ramirez, who’d struggled with maintaining these lifestyle habits after her employer fired her. Ramirez’s parents immigrated here when she was very young.
Today, she lives in the United States through DACA (Deferred Action for Childhood Arrivals) and has to renew her work permit regularly. Her employer knew her permit was expiring soon—but instead of waiting for her during the renewal process, they simply fired her.
“I lost my health insurance, and I couldn’t get insulin for a few months,” recalls Ramirez. Her blood sugars rose to dangerous levels, triggering several diabetes-related eye conditions and an emergency hospital stay for diabetic ketoacidosis (DKA).
After a few days in the hospital getting intravenous insulin and fluids, Ramirez is now getting insulin through a community clinic program until she’s able to acquire health insurance again.
Grateful to have access to insulin again, Ramirez is making an effort to be prepared for low blood sugars by keeping plenty of juice boxes at home and getting a prescription for emergency glucagon.
“But I don’t want people with type 2 diabetes to be afraid of lows,” says Ramirez. “You just have to learn how to deal with them. Lows can be scary, but I know now how they feel and what to do. I’m going to ask my doctor for a prescription for glucagon at my next appointment!”
Educational content related to severe hypoglycemia is made possible with support from Xeris Pharmaceuticals, and editorial control rests solely on Beyond Type 2.