A doctor and patient signing a form

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Thanks for joining me for Severe Low Blood Sugar Basics.

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Life is a journey and so much of it happens

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while we are busy making other plans.

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And as much as we would like, we can’t plan for everything.

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Sometimes, even when people with diabetes are taking steps

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to prevent severe low blood sugar

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life can still get in the way.

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A1C is a blood test

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that measures average blood sugar over the past 3 months.

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Because A1C doesn’t look at how your blood sugar levels vary from hour to hour,

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or from day to day, you may still be at risk

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for severe low blood sugar, regardless of your A1C level.

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Now, let’s talk about

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some of the causes of severe low blood sugar.

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In one study, people with diabetes who take insulin reported

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a range of everyday circumstances that

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can lead to low blood sugar emergencies.

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These include not eating enough food,

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unexpected or unusual physical activity,

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taking the wrong amount of insulin,

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situations that cause stress,

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changing blood sugar levels,

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and not noticing signs or symptoms of low blood sugar.

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A severe low blood sugar emergency could happen anytime, and anywhere.

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So, people with diabetes should be prepared with an emergency plan,

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just in case.

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Things to remember.

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One, you may be at risk for severe low blood sugar, regardless of your A1C level.

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Two, a range of everyday circumstances can lead to low blood sugar emergencies.

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Three, be prepared with an emergency plan

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just in case.

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Thank you for joining us for Severe Low Blood Sugar Basics.

image of a checklist

Begin Preparing for the Unexpected

Keeping a fire extinguisher in your kitchen in case of a fire or having an umbrella in your car in case of rain are common ways to plan ahead and protect yourself. So why not also plan ahead for severe low blood sugar? Sometimes, things that are out of your control can lead to a severe low blood sugar event, so begin preparing for the unexpected today.

Consider taking these steps to be ready for a severe low blood sugar event, just in case:

Create an emergency plan

Carry your medical ID

Keep glucagon with you

Get your caregivers ready to help you in the moments you can't help yourself

What Is an Emergency Plan?

An emergency plan includes important information that someone else needs to help you during a severe low blood sugar emergency. This includes:

Your name and emergency contact information

YOUR own unique signs and symptoms of non-severe and severe low blood sugar

What to do in a severe low blood sugar emergency, including where your glucagon is located and how to use it

The emergency plan template

Print out this form, fill it out, and give copies to those who are likely to be with you when you might have a severe low blood sugar event. This may include caregivers, friends, coworkers, gym staff, or teammates.

What Is a Medical ID?

A medical id wristband

It’s important for all people living with diabetes to always have a medical ID with them, regardless of the medicines they take. A medical ID provides important information about your health status to those around you. A medical ID is often worn as a bracelet or a necklace, and it includes the following health information:

  • The fact that you have diabetes
  • Diabetes medicines you take, like insulin
  • Any allergies you have
  • Your emergency contact information

Paramedics, emergency room doctors, and others who respond to health emergencies look for a medical ID when they are caring for someone who cannot speak. A medical ID can help them start the right treatment right away. Your healthcare provider can help you get a medical ID.

Two medical first responders walking

What Is Glucagon?

Glucagon is a (normal) substance in your body that protects you by telling your liver to release sugar into your bloodstream if the blood sugar becomes too low. People who have diabetes may not have enough glucagon to correct a low blood sugar.

Prescription glucagon can be used when your body does not have enough to bring your blood sugar up to a normal level. There are different types of prescription glucagon, but they all bring your blood sugar levels back up to normal.

Learn About Different Glucagon Treatment Options

Glucagon (powder and solution) for injection

Nasal glucagon

  • Mixing is required before injection
  • Store either:
    • In a refrigerator 2°C to 8°C (36°F to 46°F)
    • Out of a refrigerator 25°C (for up to 18 months within the shelf life period)
  • Do not freeze
  • Mixing is NOT required or needed (ready to use)
  • Pre-measured single dose
  • Do not store above 30°C (86°F)
  • Can be refrigerated or frozen, but is not required or needed

Glucagon injection

Dasiglucagon injection

  • Mixing is NOT required or needed (ready to use)
  • Pre-measured single dose
  • Do not store above 25°C (77°F)
  • Do not store below 15°C (59° F)
  • Do not refrigerate or freeze
  • Mixing is NOT required or needed (ready to use)
  • Pre-measured single dose
  • Store in a refrigerator 2°C to 8°C (36°F
    to 46°F)
  • Can be stored at room temperature
    between 20°C to 25°C (68°F to 77°F)
    for up to 12 months within the shelf
    life period. Do not return the
    medication to the refrigerator after
    storing at room temperature
  • Do not freeze (also keep away from the
    cooling element)

To find out which type of glucagon* may be best for you, ask your healthcare provider!

*Availability of prescription glucagon products varies by country.

Do not use glucagon products that have expired. Check the expiration date on your prescription product and ask your healthcare provider for a refill if you need one.

Are You Unsure How to Ask Your Healthcare Provider About Glucagon?

Consider asking some of the following questions:

When Should Glucagon Be Given?

Glucagon should be given if you are unable or unwilling to eat or drink a fast-acting carbohydrate on your own.

What Should Be Done After Glucagon Is Given?

  • Turn the person on their side if they are unconscious and watch for them to recover
  • DO NOT give insulin (it will lower the person’s blood sugar even more)
  • DO NOT provide food or fluids (the person may choke)
  • It typically takes 5 to 15 minutes for glucagon to work
  • If possible, check blood sugar levels to check that they are improving
  • Remember to call for emergency services

Glucagon can be given by all types of people, not just healthcare providers. Now that you have glucagon, what should you do?


Ask your healthcare provider to teach you and your caregivers how to store and use the glucagon during a severe low blood sugar event.

Keep glucagon with you, as well as
fast-acting carbohydrates.


Think about keeping glucagon in the places you stay or visit often.
This includes your home and workplace. It could also be a family member’s house, school, or your gym

Make sure your caregivers are ready
to help you!

Talk to your healthcare provider about other ways you can prepare for
a severe low blood sugar event, including creating an emergency plan and having glucagon on hand—just in case!

Review Your Knowledge

Learn More About Severe Low Blood Sugar Below

  1. Know before the low. Be prepared for low blood sugar. https://www.multivu.com/players/English/8688551-know-before-thelow/docs/TipList_1589921095033-1140242936.pdf.  Accessed November 21, 2021.
  2. American Diabetes Association. Hypoglycemia (low blood sugar). https://www.diabetes.org/healthy-living/medicationtreatments/
    blood-glucose-testing-and-control/hypoglycemia. Accessed November 1, 2021.
  3. Lilly Diabetes Canada. Rescue plan for severe low blood sugar. https://www.whatsyourrescueplan.ca/pdf/Rescue-Plan-new.pdf. Accessed November 21, 2021.
  4. Hormone Health Network. Severe Hypoglycemia. https://www.hormone.org/diseases-and-conditions/diabetes/severehypoglycemia.
    Accessed November 21, 2021.
  5. American Diabetes Association Professional Practice Committee. Diabetes Care. 2022;45(1):S83-S96.
  6. Glucagon for injection [Summary of Product Characteristics]. Gatwik, West Sussex, United Kingdom: Novo Nordisk.
    https://www.medicines.org.uk/emc/product/1289/smpc#gref. Accessed June 22, 2022.
  7. Glucagon nasal powder [Summary of Product Characteristics]. Fegersheim, France: Lilly France S.A.S.
    https://www.ema.europa.eu/en/documents/product-information/baqsimi-epar-product-information_en.pdf. Accessed June 22,
  8. Glucagon injection [Summary of Product Characteristics]. Marlow, Buckinghamshire, United Kingdom: Tetris Pharma Ltd.
    https://www.medicines.org.uk/emc/product/13093/smpc. Accessed June 22, 2022.
  9. Dasiglucagon [Prescribing Information]. Søborg, Denmark: Zealand Pharma A/S.
    https://www.accessdata.fda.gov/drugsatfda_docs/label/2021/214231s000lbl.pdf. Accessed June 22, 2022.