Glucagon Mini-Dosing | A Valuable Tool

Breakfast with Santa is something we all look forward to each year. It is simply magical to see any doubt my kids may have instantly vanish when Santa and Mrs. Claus approach them and say, “Hey, I hear you guys (insert actual fact about their lives that the Claus’ would have no way of knowing unless they were indeed real).”

Usually, Santa makes his first appearance after we are settled and have begun eating. He wanders around the room and makes small talk with everyone. After a little while, he and Mrs. Claus call the families up one by one and meet with them personally.  This year, for the first time, Santa was there and ready to go when we walked in.  We not only had a casual chat at our table, but were done with our personal time with the Claus’ before breakfast was even served.

Everyone looks happy, don’t they?

As we headed back to our seats, Caleb said his belly was bothering him. It was more than a hour after our normal breakfast time, so I attributed it to hunger. I asked him if he was ready to eat, to which he replied, “yes”, and I bolused. Pancakes were retrieved and Caleb began eating.

Caleb ate slowly and very little. He decided that the sight and smell of food was unappealing. He took a sip of juice and waved that away too.

I had just bolused him with 4 units of insulin. 4 units is about twenty percent of Caleb’s total daily dose.

I coaxed him to drink his juice – maybe the insulin was kicking in and he’s starting to feel low and a little boost will make him feel better.

It didn’t. He heaved.

At this point David and Colin had left for another commitment of Colin’s. Lila was distracted with various Christmas crafts.

I quickly swept Caleb away to the bathroom and anything he had just ingested came back out like a fire hose.

“No need to panic”, I told myself.

Caleb felt better after getting all that up. Maybe this was just a one time thing and he would have his appetite back.

No such luck. He threw up 2 more times over the course of the next half hour.

I knew the urgency of the situation. I knew I might need to get him to the hospital for a glucose drip and intravenous hydration. Still, there was no panic. I had the benefit of knowing a course of action that could avoid a trip to the emergency room.

Mini-glucagon.

I distinctly remember the details of Nan’s story in a similar situation. I remember how alarmed I felt when I read it the first time, picturing her and C going through every single step. The thought of using glucagon in mini doses that way was a new idea to me. I only had the frame of reference we were given when Caleb was diagnosed:

  • Use glucagon in an emergency only.
  • Use glucagon if Caleb has a severe hypoglycemic episode and can’t eat anything.
  • Try squeezing glucose gel in his cheek first.
  • Use glucagon if he’s unconscious and nothing else works.
  • Use it as a last resort.
  • We hope you never have to use it.

But thanks to Nan’s story, I knew that glucagon could be used in a less severe, though equally urgent situation. I pulled it out and put it on the table. I explained to Caleb that if he couldn’t eat, I would be able to cover the bolus with a shot. After a few more attempts to drink, he looked at me and said, “Mom, let’s do the shot.”

So that’s what we did. He pulled up his sleeve and I injected him with 5 units. Almost instantly, he looked better. He was soon feeling better and able to do a craft with his sister.

After a little while, a fingerstick of 89, and quite a bit of insulin still working in him, I gave him another injection of 5 units.

We finished everything we needed to and Caleb seemed to be at a safe blood sugar for transport. So we made our move.  If anyone around us had a clue what was going on, they didn’t make it known.

We got home and I tucked Caleb into bed and made him comfortable. He was a safe 134 and we were out of the danger zone.  He was able to keep down enough fluids to stay hydrated and his blood sugar remained stable.

Thank you to my friends who have shared their own glucagon stories and thus given me the confidence and composure to handle this. Without the benefit of your combined stories, I’m certain things would have gone very differently.

I thought I would never want to be part of the “Glucagon Club” but in fact I am glad to be in it. Given the circumstances of that morning, mini glucagon seems like an easy fix compared to any other alternatives I can think of.

Lastly, and maybe most importantly, thank you Santa for being early this year.  Someone was watching over us to make sure that we could have that moment of joy. Our memory of that morning is mostly of our meeting with Mr. and Mrs. Claus which just happened to be followed by an unfortunate series of events. Had we eaten breakfast first like we normally do, those pictures above would be at least one person shy.

For more information on glucagon, here are the resources and stories that prepared me:

Note: the recommended dosing for mini glucagon is as follows:

  • ages 2 years and under: 2 units
  • age 2 to 15 years: 1 unit  for each year of age (6 units for a 6 year old, etc.)
  • age 15 years and older: 15 units

I used a standard insulin syringe (not the harpoon included in the kit).

Caleb’s recap of these events is here.