Part 1: What Is Glucagon & When to Use It

What you'll learn

Understand what glucagon is and how it works
Know when glucagon should be used (and when it should NOT)
Compare the three types of glucagon available today
Identify the right glucagon form for your situation

What Is Glucagon?

Glucagon is a life-saving hormone that rapidly raises blood sugar. It's produced naturally by alpha cells in the pancreas and works as the direct opposite of insulin:

Insulin lowers blood sugar by helping cells absorb glucose
Glucagon raises blood sugar by signaling the liver to release stored glucose (glycogen)

When injected or inhaled during a severe low, glucagon can raise blood sugar within minutes — potentially saving a life.

Info

Every person with T1D should have at least one unexpired glucagon kit accessible at all times. The ADA Standards of Care 2026 recommend prescribing glucagon to all individuals at risk of Level 2 or Level 3 hypoglycemia — and that includes anyone on insulin.

When to Use Glucagon

Use glucagon when someone:

Is unconscious or unresponsive
Is having a seizure
Cannot safely swallow
Is too confused to eat or drink
Is not responding to oral glucose treatment

Do NOT give glucagon if:

The person can safely eat or drink (use the 15-15 rule instead)
It's been less than 24 hours since a previous glucagon dose (liver glycogen stores may be depleted)

The Three Types of Glucagon

Feature	Traditional Kit	Baqsimi (Nasal)	Gvoke (Auto-injector)
Administration	Injection (mix first)	Nasal spray	Pre-filled injection
Preparation	Must mix powder + liquid	None required	None required
Age approval	All ages	Age 1+	Age 2+
Storage	Room temp or refrigerated	Room temperature	Room temperature
Ease of use	Most complex	Easiest	Very easy

Tip

Baqsimi nasal glucagon is now approved for patients aged 1 and older (previously limited to age 4+). Gvoke is approved for age 2+. These newer formulations are much easier to administer under stress than the traditional kit.

Scenario: Maria's First Glucagon Decision

Maria, 34, has had T1D for 12 years. She comes home to find her partner, David, sitting on the couch staring blankly. She calls his name — no response. She checks his CGM: 38 mg/dL with a downward arrow.

She grabs the Baqsimi from the kitchen drawer. She knows David can't safely swallow anything in this state. She inserts the nasal device, presses the plunger, and calls emergency services. Within 12 minutes, David starts to stir.

What Maria did right:

Recognized the emergency signs (unresponsive, very low BG)
Did NOT try to give food or liquid (choking risk)
Used glucagon immediately
Called emergency services
Stayed with David

Key takeaways

Glucagon signals the liver to release stored glucose — it works opposite to insulin
Use glucagon for emergencies: unconsciousness, seizures, inability to swallow
Three forms available: traditional injectable, Baqsimi nasal (age 1+), Gvoke auto-injector (age 2+)
Newer forms (Baqsimi, Gvoke) require no mixing and are much easier under stress
Every person on insulin should have unexpired glucagon accessible at all times

Quick Check: Glucagon Basics

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When should glucagon be used instead of the 15-15 rule?

What Is Glucagon & When to Use It