Minidose glucagon injection

For children and adolescents with type 1 diabetes, if there is an imminent risk of hypoglycaemia (blood glucose concentration less than 4.4 mmol/L) or nonsevere hypoglycaemia is present, and oral intake of glucose is impractical (eg vomiting, young child refusing to swallow), a glucagon ‘minidose’ can be given. The dose to treat nonsevere hypoglycaemia is age-dependent; give1:

1 glucagon (2 years or younger) 20 micrograms (2 units given by 100–unit insulin syringe) subcutaneously or intramuscularly hypoglycaemia, nonsevere (child with diabetes) glucagon    

OR

1 glucagon (3 to 15 years) 10 micrograms per year of age up to 150 micrograms (1 unit per year of age up to 15 units, given by 100–unit insulin syringe) subcutaneously or intramuscularly. hypoglycaemia, nonsevere (child with diabetes) glucagon    

Children may take up to 20 minutes to respond to the glucagon. Check the child’s blood glucose concentration 30 minutes after giving the glucagon and if it has not increased, give double the initial glucagon minidose.

If the child has responded to the glucagon minidose but oral intake has not resumed, the dose can be repeated after 2 to 3 hours.

If regular oral intake has not resumed and nonsevere hypoglycaemia is ongoing, the child should be admitted to hospital for an intravenous glucose infusion.

1 For a glucagon minidose, use a 100-unit insulin syringe to draw up a reconstituted glucagon 1 mg/mL injection. One unit from the insulin syringe equals glucagon 10 micrograms.Return