Anyone who manages diabetes using insulin is at risk of experiencing hypoglycemia. This means hypoglycemia.
Most hypoglycemia can be managed by eating and drinking carbohydrates, but some are very serious and require assistance in treating them and regaining blood sugar levels. These episodes are defined as severe or severe hypoglycemia.
Severe hypoglycemia is serious and can occur when you are least expecting it.
We discussed hypoglycemia in detail previously and explained how to use GvokeTM Predicted glucagon products to restore blood glucose levels to a safe range. What happened since we last discussed Gvoke is that the automatic injector GvokePypensTM (Glucagon injection) is now available.
This is very exciting. Because there is another simple way to manage glucagon. Like the ready-made syringes (Gvoke PFS), Gvoke Hypopen is a pre-penetrating product, but with Gvoke Pypopen you (or the person who administers the product) will not see the needle and the dosing process is very intuitive.
But I’ve talked about severe hypoglycemia before and how to treat it, but I don’t think we’ll talk enough about severe hypoglycemia.
Maybe you’ve never experienced severe hypoglycemia, or maybe you’ve had some. Anyway, talking about severe hypoglycemia can help make it clearer, reduce the shame that some people feel about severe positives, and if it happens to us, we can start a dialogue about how to make sure it’s being addressed properly.
This post is by Xeris Pharmaceuticals, Inc. is sponsored by.
The true story of severe hypoglycemia
In late May 2020, I had the opportunity to talk to a member of the strong Facebook community with diabetes about my experiences with severe hypoglycemia.
In this story, I would like to show that severe hypoglycemia can occur in anyone at a time that is usually inconvenient. And I want to show how important it is that people around us know how to act in cases of severe hypoglycemia and have the right tools available.
This is Katie’s story.
Katie Reno was diagnosed with type 1 diabetes at age 31 years (January 1989). She has been using insulin pumps for many years to manage diabetes and in recent years added a continuous glucose monitor (CGM) to her diabetes toolbox.
Katie grew up in South Dakota and lives in Huron with her husband Jared and two teenagers Jackson and Gillian. She featured CrossFit two years ago and is now a CrossFit Level 1 trainer, and is the healthiest of all time.
The whole family is involved in Katie’s diabetes management, and she explains how she hides glucose pills in every floor in her tall brick home.
Severe hypoglycemia during holidays
Katie and Jared travel to Cabo, Mexico every year to get a resort holiday on the beach. On this particular day in the spring of 2018, they were relaxing in the pool all day, ready to go for dinner at the resort’s favorite restaurant.
It was a special night, so Katie dressed up. She didn’t want to bring her wallet for dinner, so she left her diabetic equipment in the room. She knew the restaurant menu they had booked, what she wanted to eat, and how long it would take to get there, so she decided to inject bolus with insulin in advance before leaving the room, before they left the room (about 6-8 units of rapid insulin).
On their way to the restaurant, they bumped into Bruce Johnston (a member of the Beach Boys) in the lounge, and of course they couldn’t miss the opportunity to chat for a while. Katie enjoyed some appetizers in the lounge, but didn’t think about it much. They were in the lounge for about an hour before departing for the restaurant, but that’s when Jared realizes something is wrong.
Katie was having trouble walking now (and she wasn’t drinking), and she collapsed and began to in and out of consciousness. The resort staff offered to send medical assistance, but they were very close to the room and were with another couple, so Jared ran to the room and got glucose pills. But that wasn’t enough, and she read her blood sugar level as “low.”
Katie was driven into her room in a wheelchair, and Jared gave her a gulcagon shot, waiting for her to return to her full cognitive self.
He continued to feed her, her blood sugar level came out, exceeding 250-300 mg/dL (14-18 mmol/l), and at this point she felt silly, but she was completely conscious and wary. It took me a few hours to balance her blood sugar levels, and this was before she got her CGM, so she measured her blood sugar levels every hour.
The emotional effects of severe hypoglycemia
Katie said he was scared and worried while Jared kept his cool throughout the experience. The worst part for him was waiting for her blood sugar to rise as she began to run through the horrifying “what’s wrong” scenario in his head.
Meanwhile, Katie felt guilty. A shameful guilt for being at the heart of the situation and “causing the scene.” Fortunately, they have had strong relationships and have worked together on those feelings by talking about them rather than trying to restrain them.
Other episodes
In the past, Katie used glucagon every 3-5 years, but as it was so low in Kabo, Katie’s blood sugar level wasn’t that low, so she needed glucagon to get it back to normal levels.
Another horrifying episode was five or six years ago when she drove a recital with her daughter dancing. She managed to pull the car, and was fortunate enough to have the police car pulled up next to her, and her daughter was able to explain the situation. At that moment, an ambulance was called and they restored her blood sugar level.
What Katie wants you to know about serious worst
For a long time, Katie thought it was her alone. She had bad diabetes and was the only person who had experienced severe hypoglycemia. She now realizes that this is not the case, and that’s why she wants to share her story.
You can do everything right or have the best intentions and things may not work out yet.
Her key points are always to prepare, always have a backup plan, listen to your body and learn the signals it sends to you. She currently has glucose pills in every wallet, every floor in the house, and in the car. When they travel, Jared has a glucagon kit in his bag. At home, it’s in his drawer.
Prepared for severe hypoglycemia
Katie shows her vulnerability and appreciates her willingness to share her story with us. That’s because it underscores the importance of talking about severity and taking appropriate precautions when you live with insulin-dependent diabetes.
My takeaway is that from living with diabetes and discussing severe hypoglycemia situations with others, some very important steps will help you stay safe.
- Frequently measure blood sugar levels and take appropriate situational actions immediately
- Always carry glucose quickly, such as glucose tablets and juices
- I always have glucagon products like Gvoke Hypopen TMand know when and how to use it
Even if you have never used Glucagon, if you are in the situation you need it, remember that it will be of no use if you don’t meet your prescription.
How to get Gvoke TM
After discussing with Glucagon and your doctor and learning when to use it, you will need to receive your prescription at a pharmacy or online delivery, which is met by Amazon’s company Pillpack. (If you want to deliver it to your home, the information is available at gvokeglucagon.com).
Visit gvokeglucagon.com to learn more about our limited time-free $0 Copay products for commercially eligible patients.
Important Safety Information
Gvoke is a prescription drug used to treat very hypoglycemia (severe hypoglycemia) in children and children with diabetes who are older than 2 years old. It is unclear whether Gvoke is safe and effective for children under the age of 2.
Do not use Gvoke if you have a tumor in the gland above the kidney (adrenal gland), known as a nephrocytoma. There is a tumor in the pancreas, called insulinoma or glucagonoma. You are allergic to glucagon and other inactive ingredients in Gvoke.
Gvoke can cause serious side effects, including hypertension. Gvoke can cause hypertension in certain people with tumors in their adrenal glands.
Hypoglycemia: Gvoke can cause hypoglycemia in certain people with tumors in the pancreas.
Serious Skin Rash: Gvoke can cause serious skin rashes in certain people with tumors in the pancreas called Glucagonoma.
Serious Allergic Reactions: If you have a serious allergic reaction, such as rash, difficulty breathing, or hypotension, call your doctor or get immediate medical assistance.
Please refer to important safety information
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