Handling a Mid-Flight Diabetes Emergency: A Real-Life Experience with Gvoke HypoPen^®

The Friends for Life Orlando 2024 conference may be in our rearview mirror, but what we learned from the event will live on in our hearts for all the days to come. We had the highest of highs and the lowest of lows. Sometimes, those lowest moments happen at the most inopportune times — like when you’re over 10,000 feet in the air on an airplane with more than 30 minutes left until landing.

Our trip home was eventful, to say the least. I want to share our experiences with the diabetes community in case it may be helpful for you in the future.

An early morning start
Our journey back to North Carolina began at 3 am. We had one of the first flights of the day out of Orlando, and due to the early start, we didn’t have time to eat breakfast or carb up before leaving. We navigated through security with ease. But on the other side of security, Ava, my daughter, started to go low. She had been coasting in the low 100s and seemed fine — but the stress of traveling, lugging a heavy suitcase, and all the walking in the airport led to a drop in her blood sugar.

We managed the first low before boarding our flight by getting some food and carbs into her system. By the time we landed in Atlanta, her blood sugar was in the upper 200s, so we decided to bolus her with insulin to correct it.

The unexpected drop
Our layover in Atlanta was brief, and we had to rush from one terminal to the next. We boarded quickly, and once in the air, Ava and her boyfriend, whom we affectionately call #17, settled into their seats. Then, we started hearing the alarms. First, the rapidly falling alarm on Ava’s continuous glucose monitor (CGM) went off. Then, as we watched the numbers fall every 5 minutes, the low alarms began to sound.

At 10,000 feet, I realized we were in trouble. I went to the front of the plane and explained the situation to one of the Delta Air Lines flight attendants, who was incredibly helpful. She gave me a can of juice and several packs of cookies. Ava took a few sips of the juice and ate about half of a cookie, but her blood sugar continued to drop.

The moment of truth: Administering Gvoke HypoPen^® (glucagon injection) on the plane
During the ADA Scientific Sessions conference, I spent time with our partners from Xeris Pharmaceuticals^® at our Children with Diabetes Lunch and Learn event. We discussed creating a standard of care for ready-to-use glucagon and learned more about Gvoke HypoPen^®, a rescue pen that can be used before someone passes out or becomes unconscious from very low blood sugar. On the day we traveled home from Orlando, I had Gvoke HypoPen 2-pack™ in my work backpack under my seat on the plane.

As Ava’s blood sugar continued to drop, she quietly whispered that she couldn’t drink or eat anything more. I was afraid of where this was going. We were almost 30 minutes from landing, and I needed to act. Her blood sugar was in the low 40s, and she was starting to fade.

I grabbed Gvoke HypoPen and administered it right there on the plane. For those who haven’t used it, there is a red safety cap that must be removed before injecting. In the heat of the moment, I forgot about that part and tried to inject it with the safety cap still on, but the device wouldn’t administer until I removed it.

The aftermath — and the power of being prepared
This was the second time in a month that I’ve used glucagon on my daughter. I’ve been a diabetes mom for almost 12 years now and never thought I would need it once, much less twice, in such a short period. This time was different than the last. Ava wasn’t unresponsive, and we took every action we could to prevent this low, but diabetes had a mind of its own. However, we were able to treat this low blood sugar emergency, thanks to the tools we had in our backpacks and purses and the lessons we’ve learned from attending conferences, educational events, and from others in the diabetes community.

Here’s what I want to tell you: Gvoke HypoPen worked. Within 15 minutes, Ava’s blood sugar started to rise, and by the time we landed in Wilmington, she was back in the 100s. #17 held her hand as we exited the plane.

Final thoughts
I hope you never have to use glucagon. I hope your blood sugars respond to more traditional treatments for lows. I hope you remain clear-headed enough to make decisions in medical emergencies. I hope you have the support of flight attendants, industry partners, trusted friends who have become family, and, in Ava’s case, a loving lacrosse-playing boyfriend. I hope it never happens to you.

But if it does, this is how you do it.

This blog post is a personal account shared by Leigh Fickling Davis, Chief Operating Officer of Children with Diabetes^®. Individual results may vary. Gvoke HypoPen^® is a prescription glucagon for the treatment of very low blood sugar in people with diabetes ages 2 and above. 

In certain situations, patients can self-administer Gvoke HypoPen. Always consult your healthcare provider to see if Gvoke HypoPen is right for you or your loved one.

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