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Baqsimi™ (glucagon) nasal powder
3mgThis information is provided in response to your request. Resources may contain information about doses, uses, formulations and populations different from product labeling. See Prescribing Information above, if applicable.
Hypoglycemia Prevention
Prevention of hypoglycemia is a critical part of diabetes management; however, when hypoglycemia occurs, current treatment guidelines should be followed.1-3
American Diabetes Association
Health care providers should ask individuals at risk for hypoglycemia about symptomatic and asymptomatic hypoglycemia at each visit.1
In a conscious individual with a BG of <70 mg/dL (<3.9 mmol/L),
glucose (15 to 20 grams) is the preferred treatment but any form of carbohydrate containing glucose may be used
if SMBG continues to show hypoglycemia 15 minutes after glucose treatment, the glucose treatment should be repeated, and
a meal or snack should be consumed once SMBG returns to normal to prevent hypoglycemia recurrence.1
Glucagon should be prescribed and available to individuals with an increased risk of level 2 hypoglycemia, defined as a BG of <54 mg/dL (<3.0 mmol/L).1
The use of glucagon is indicated for the treatment of severe hypoglycemia in people unwilling or unable to consume carbohydrates by mouth.1
Family members, caregivers, coworkers, and school personnel should know
where glucagon is located
when to administer glucagon, and
how to administer glucagon.1
A person's treatment regimen should be reevaluated when there is
hypoglycemia unawareness, or
1 or more events of level 3 hypoglycemia, defined as a severe event characterized by altered mental and/or physical status requiring assistance for recovery.1
A insulin-treated person with hypoglycemia unawareness or a level 2 hypoglycemia event should increase their glycemic targets to
avoid hypoglycemia for several weeks,
reverse hypoglycemia unawareness, and
reduce the risk of hypoglycemic events.1
International Society for Pediatric and Adolescent Diabetes
In children, if the BG is <70 mg/dL (<3.9 mmol/L), 0.3 g/kg of carbohydrate in the form of glucose should be given.2
Hypoglycemia resolved in most children given 0.3 g/kg of rapidly acting carbohydrate and increased the median BG at
10 minutes by 18 to 23.4 mg/dL (1.0 to 1.3 mmol/L), and
15 minutes by 36 to 37.8 mg/dL (2.0 to 2.1 mmol/L).2
No rebound hyperglycemia was observed at the following meal.2
The BG level should be rechecked after 10 to 15 minutes and if hypoglycemia continues, oral carbohydrate intake should be repeated.2
Typically, a rapidly acting carbohydrate can be followed with a slower acting carbohydrate.2
The amount of the carbohydrate needed will depend on
the size of the child
the type of insulin therapy
the active insulin on board
the timing and intensity of exercise, and
other factors.2
Insulin administration should typically be held if the BG level is <56 mg/L (2.0 mmol/L).2
Urgent treatment of severe hypoglycemia can be treated with glucagon or IV glucose in the hospital setting.2
Caregivers need to understand that a child will be at a higher risk of other hypoglycemic events following a severe hypoglycemic event and changes in therapy may need to occur.2
References
The published references below are available by contacting 1-800-LillyRx (1-800-545-5979).
1. American Diabetes Association. 6. Glycemic Targets: Standards of Medical Care in Diabetes-2019. Diabetes Care. 2019;42(suppl 1):S61–S70. https://doi.org/10.2337/dc19-SINT01
2. Abraham MB, Jones TW, Naranjo D, et al. ISPAD Clinical Practice Consensus Guidelines 2018: Assessment and management of hypoglycemia in children and adolescents with diabetes. Pediatric Diabetes. 2018;19(suppl 27):178-192. https://doi.org/10.1111/pedi.12698
3. International Hypoglycaemia Study Group. Minimizing hypoglycemia in diabetes. Diabetes Care. 2015;38(8):1583-1591. http://dx.doi.org/10.2337/dc15-0279
Glossary
BG = blood glucose
IV = intravenous
SMBG = self-monitored blood glucose
Date of Last Review: January 25, 2019
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