Sick day management: mini dose glucagon 

Mini doses of glucagon may be used to treat hypoglycaemia when unable to tolerate food or fluids.

For example: If your child’s blood glucose level (BGL) is low (less than 3.9 mmol/L), and feels too sick to eat/drink ‘hypo’ treatment.                           

The Glucagon Hypokit consists of:

Glucagon Hypo Kit

and

Syringes:  Ideally get either the 30 unit or 50 unit insulin syringes at home to draw up the mini dose glucagon. Using the smaller volume syringe helps with drawing up the dose accurately. 

Mini dose glucagon is a very effective  and safe treatment used in children who are hypoglycaemic (Low BGL) as a result of a vomiting illness like gastro and cannot tolerate food or are refusing food due to nausea. Glucagon works by sending a message to the liver and muscles to release stores of glucose to help raise the internal blood glucose levels.  Mini dose glucagon can be administered up to 3 times to stabilise blood glucose levels.

Step 1 

Make up the mini dose Glucagon as follows:

• Remove the orange plastic cap from the bottle of white powder (glucagon) and the needle guard from the syringe containing sterile water
• Using the syringe in the kit inject all the water in the syringe into the glucagon vial through the bulls eye in the centre the vial.
• Remove the needle and keep the syringe in case it is later needed.
• Using an insulin syringe draw up the glucagon solution using the table below for the dose.
• Administer the solution as you would an insulin injection

When glucagon has been diluted it can be used for the next 24 hours 

Step 2

Recheck BGL in 30 minutes

Step 3

• Recheck BGL in 30 minutes.
• If BGL remains below 5.5 mmol/l give a third dose. This dose 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 maintained above 5.5 mmol/l
• Call the hospital sick day pager (see below) for support and advice

  Call the hospital if any of the following occur:

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

Call the hospital switchboard on 9345 5522 and ask for the “diabetes sick day service”