Guidelines for using glucagon

The ADA Standards of Care recommends prescribing glucagon for all individuals at increased risk of level 2 (moderate) hypoglycemia so it’s available if needed.1

Patients may be at risk of hypoglycemia for a variety of reasons:1-4
Management-related factors
  • Aggressive glycemic control
  • Inadequate glycemic control/adherence
  • Glycemic variability
  • Pump or injection errors
  • History of stacking insulin doses
  • Bolusing without testing
Lifestyle or individual factors
  • High-intensity physical activity
  • Skipped or irregular meals
  • Erratic schedule
  • Stress
  • Alcohol use
  • Poor cognitive status or psychological disorders
  • Increased insulin sensitivity
  • History of severe hypoglycemia
  • Hypoglycemia unawareness
  • Duration of diabetes
  • Comorbidities

Gvoke should be used when any of the following are true:5,6

Patient has tried correcting hypoglycemia sugar (or drinks that are high in sugar) and has not improved

Patient is unable to safely swallow sugar or sugar-sweetened products to correct hypoglycemia

Patient feels like they might pass out

Patient experiences loss of consciousness or a seizure

Patients can even give themselves Gvoke
in certain situations

Those around patients should be shown how to use Gvoke before an emergency happens. They may need to administer it if the patient has a severe low blood sugar event.

Gvoke can be used even before the patient passes out
Gvoke can be used even before the patient passes out

The ADA recommends glucagon be used in people unable or unwilling to eat.1

References: 1. American Diabetes Association. Glycemic targets: Standards of medical care in diabetes—2019. Diabetes Care. 2019;42(suppl 1):S61-S70. 2. National Institute of Diabetes and Digestive and Kidney Diseases. Hypoglycemia. https://www.niddk.nih.gov/-/media/Files/Diabetes/hypoglycemia_508.pdf. Published October 2008. Accessed June 4, 2019. Published August 2016. Accessed May 28, 2019. 3. Kedia N. Treatment of severe diabetic hypoglycemia with glucagon: an underutilized therapeutic approach. Diabetes Metab Syndr Obes. 2011;4:337-346. 4. Geller AI, Shehab N, Lovegrove MC, et al. National estimates of insulin-related hypoglycemia and errors leading to emergency department visits and hospitalizations. JAMA Intern Med. 2014;174(5):678-686. 5. Gvoke Pre-Filled Syringe [instructions for use]. Chicago, IL: Xeris Pharmaceuticals, Inc. 6. Gvoke HypoPen [instructions for use]. Chicago, IL: Xeris Pharmaceuticals, Inc; 2020. 7. Gvoke [prescribing information], Chicago, IL; Xeris Pharmaceuticals, Inc.