What is a Glucagon?
Glucagon is a hormone that helps keep your blood sugar from dropping too low. Like insulin, it’s released by the pancreas to keep blood sugar stable. While insulin moves sugar into the cells to be used for energy or stored for later, glucagon tells the liver to release stored sugar when levels run low.
Think of them as working like a thermostat: insulin lowers blood sugar when it’s too high, and glucagon raises it when it’s too low. In diabetes, this balance can be disrupted. The body may not make enough insulin, may not use it properly, or the signals for glucagon may not work as they should.
When is Glucagon Needed?
Glucagon is a rescue treatment for dangerously low blood sugar, also called hypoglycemia. The American Diabetes Association (2024) describes three stages of low blood sugar:
- Level 1 (below 70 mg/dL): Usually manageable with something sugary, like half a cup of orange juice or four glucose tablets. The 15-15 rule works well here—take 15 grams of fast-acting carbs, wait 15 minutes, then recheck.
- Level 2 (below 54 mg/dL): More serious and needs quick action. If the person is awake and able, follow the 15-15 rule with juice, glucose gel, or tablets. Glucagon should be ready, and outside help may be needed.
- Level 3 (severe low): The person may be confused, unable to treat themselves, or even unconscious—no matter the blood sugar number. 🚨 This is an emergency. Glucagon and outside help are required right away.
🔖 Anyone taking medications that can cause low blood sugar—like insulin, sulfonylureas (glimepiride, glipizide), or meglitinides (repaglinide, nateglinide)—should have glucagon on hand. A history of severe lows is also a strong reason to keep it nearby. Glucagon saves lives!
🔖 For people at higher risk, using a continuous glucose monitor (CGM) is also recommended to catch lows early and help prevent emergencies.
Glucagon should be used when:
- The 15-15 rule isn’t working
- You can’t swallow carbs safely
- You feel you may pass out or lose consciousness
Ways Glucagon Can Be Given
Glucagon comes in several delivery options that your doctor can prescribe. You and your doctor will decide which one works best for you. No matter which type you use, always follow the manufacturer’s instructions carefully. If you ever need to give glucagon, remember to turn the person on their side to prevent choking, since nausea and vomiting are common side effects.
Identify Your Support System
It’s not enough to just have glucagon—your support system should know how to use it. This may include a partner, family member, friend, or coworker. They should know:
- Common symptoms of low blood sugar
- Where to find your glucagon kit
- How to give Glucagon
- To turn you on your side in case of vomiting
- To call 911 if needed
If you’ve been prescribed glucagon, talk through this information with the people closest to you.
Takeaways
- Glucagon raises blood sugar when it drops too low, working opposite of insulin.
- It’s most important for severe lows (below 54 mg/dL) or when you can’t eat or drink.
- Anyone on insulin, sulfonylureas, or meglitinides—or with a history of severe lows—should have glucagon.
- Glucagon comes as an injection or nasal spray—ask your doctor which option is right for you.
- Make sure your support system knows how and when to use glucagon in an emergency.
📌 Glucagon Saves Lives!
References
1. American Diabetes Association. (2024, April 1). How to use glucagon. https://diabetes.org/living-with-diabetes/hypoglycemia-low-blood-glucose/how-use-glucagon
2. American Diabetes Association. (2024). Standards of care in diabetes—2024: Glycemic goals and hypoglycemia (Table 6.4, Classification of hypoglycemia). Diabetes Care, 47(Supplement 1), S111–S125. https://diabetesjournals.org/care/article/47/Supplement_1/S111/153951