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Diabetes in children: preparing glucagon for injection DIABETES IN CHILDREN: PREPARING GLUCAGON FOR INJECTION
Glucagon is prepared as a dry powder
Glucagon is manufactured as a dry powder. It deteriorates quickly after it has been dissolved as a solution, so it is stored as the dry powder, and sterile water is provided to dissolve it when it is needed. Do not mix until it is actually required.
How to dissolve the glucagon
A Using glucagon hypo kit
1. Remove the cap from the vial. Remove the needle guard.
2. Inject all the sterile water from the syringe into the vial containing the tablet of glucagon. Do not withdraw the needle from the vial.
3. Shake the vial with the needle and syringe still inserted until the glucagon is completely dissolved.
4. Slowly draw the dose up into the syringe keeping the tip of the needle below the level of the glucagon solution.
? Using glucagon supplied with vial of water
1. Remove the protective caps from the rubber stoppers of both vials.
2. Use a 1ml. insulin syringe. Draw back the plunger to the 100 unit mark to fill the syringe with air.
3. Plunge the needle into the bottle of water and inject air into the vial in the same way as you would when drawing up insulin.
4. Draw up all the water into the syringe just as if you were drawing up insulin. Don't worry about air bubbles - they don't matter. Don't worry if you don't get all the water.
5. Now insert the needle into the vial with the powder of Glucagon and inject all the water into the vial.
6. Remove the needle and mix the powder with the water by inverting the bottle back and forth. Sometimes it is hard to dissolve, and if you leave the needle in the bottle you may lose some of the solution.
7. Put the needle back into the bottle (no need to inject any air) and draw out all the solution. Don't worry if you miss a bit - the dose doesn't need to be precise. Get rid of large air bubbles but small ones do not matter. They will cause no harm if injected beneath the skin.
? Injecting the glucagon
Now inject all of the Glucagon under the skin just like an insulin injection. Inject it anywhere that is convenient and where you inject insulin.
Glucagon may take five to fifteen minutes to work. As soon as your child wakes up a bit, give glucose or sugar or honey by mouth. Glucagon works only temporarily and you should give sugar as soon as possible and repeat this until the blood sugar value rises above 5 mmol/l.
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