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Diabetes at the RCH

Mini dose glucagon for sick days

  • Sick day management: mini-dose glucagon 

    Mini-dose glucagon is a very effective and safe treatment used in children who are hypoglycaemic (BGL below 4 mmol/L) and cannot tolerate or are refusing food due to nausea or vomiting. Glucagon works by sending a message to the liver to release stores of glucose which raises the blood glucose levels. Mini-dose glucagon can be given up to 3 times, after which medical help should be given.

    You must not use mini-dose glucagon protocol if your child has severe hypoglycaemia – decreased consciousness or fitting – a full dose of glucagon is needed urgently                      

    Your Glucagon Hypokit should include:

    the GlucaGen® HypoKit® orange box containing the vial of glucagon and a syringe of sterile water

    glucagon

    and

    a 30 or 50 unit insulin syringe: to draw up the glucagon once mixed with water. 

    30 unit insulin syringe  

     

    50 unit insulin syringe


    Step 1 

    Make up the mini dose Glucagon as follows:

    • Open the orange box and remove the orange plastic cap from the bottle of white powder (glucagon) and the needle guard from the syringe containing sterile water
    • Inject all the water in the syringe into the glucagon vial through the bulls eye in the top of the bottle.
    • Remove the needle and keep the syringe in case it is later needed.
    • Using an insulin syringe, draw up the required glucagon dose using the table below.
    • Give the glucagon as you would an insulin injection

    When glucagon has been mixed with water,  it can be stored in the fridge and used for the next 24 hours 

    dose guide

    Step 2

    Recheck BGL in 30 minutes

    step 2 mini dose

    Step 3

    • Recheck BGL in 30 minutes.
    • If BGL remains below 5.5 mmol/l give a third dose. The dose to give is the same as the 2nd dose.
    • Continue to offer small amounts of sweetened fluids and food and refer to sick day management guidelines.
    • Monitor BGL’s hourly if BGL is maintained above 5.5 mmol/l 


      Call your treating medical team if any of the following occur:

    • Your child vomits 3 times within a few hours
    • Your child’s BGL is less than 5.5 mmol/l after 3 doses of mini dose glucagon
    • You are unsure what to do

    If you are an RCH patient, to access sick day advice call the hospital switchboard on 9345 5522 and ask for the “diabetes sick day service”