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Glucagon Stability?

I’ve been EXTREMELY lucky in my 32 years with Type 1 that I have never needed a glucagon injection. I’m fortunate to feel lows coming on pretty quickly, and the lowest I’ve been is 45. My concern is that I don’t feel them coming on quite as early as I did in the past, and I feel I and my husband need to be prepared to use it at some point and we’re going to watch some videos together on it. I know it should be refrigerated, but I usually keep one right at the front of my diabetes supplies shelf so my husband could grab it if needed. Does it lose stability after a particular amount of time, or does it still work?

  • #119184
  • That is a good question Angie, something I wondered about. Over the past 58 years I’ve purchased several of these “fire extinguisher” kits only to discard then when they went well beyond the quoted expiration date. Although I’ve had BG readings in the 20s no one has had to use glucagon to help me respond – until 2 years ago, after my wife disposed of my remaining glucagon kits she had to call EMS to revive me.

    Much like you, during more than 50 years with T1D I’d feel lows coming on and take appropriate action; now the lows tend to sneak yp unannounced. I should probably yield to progress and venture into CGM. And hopefully this year Congress will order the Medicare administrators to honor commitments and provide at least partial coverage for CGM.

    I apologize for venturing into politics on this site.

  • #119185
  • Thanks, Dennis. I too wish CGM were covered for seniors…in fact I saw they just started a Facebook group called “Seniors with sensors” to try to advocate for this, so you might want to check it out! I have the Enlite CGM but have had dreadful luck with it, unfortunately. About 2/3 of my sensors poop out on me due to weak signals and lost sensors, and dozens of troubleshooting calls and appointments with MM have not helped. I’m not thin, but apparently too muscular to avoid kinking the filament, no matter where I put it on my body. I know they’re working on some other options, similar to a range of infusion sets, but it can’t come soon enough. Maybe your endo can arrange with MM to let you try out the CGM for a few days to see how it works before you invest the money.

  • #119186
  • @angivan,

    every glucagon kit I ever saw was a lyophilized powder and a small vial of what I would guess is water and buffer. I am pretty sure it is stored at room temp and could last a year…or more. The lyo powder form would keep the hormone fairly stable for a minimum of a year. I would guess the vial has a better chance of losing sterility over time. sorry I don’t have better information.

  • #119187
  • Thanks, Joe…they are just so god-awful expensive that I don’t want to pitch them and keep getting new ones, especially since I haven’t even had to use one yet. My insurance covers a little bit of them, but they consider it a “non-essential” (luxury???) item. It’s like they consider it our fault when we go low so we should be punished by having to pay for it. (sigh)

  • #119188
  • it may be worthy of an appeal. it’s arguable that glucagon is as necessary as an epi pen would be for anaphylaxis. i am starting to hate insurance companies. With the artificial pancreas project there will be some incentive to make cheaper formulations of glucagon, so maybe it won’t be like this forever.

    good luck!

  • #119195
  • I see this thread is 6 months old but it has some significance to what I experienced today so I thought I would reply, better late than never, right? 🙂 I have been waiting for weeks to find out if my insurance company was going to approve a pump and a CGM. I found out today that they approved the pump but denied the CGM because I haven’t had severe enough hypos, which seems ridiculous to me. I would like to see their criteria, or have them give me a reason why they even have criteria for T1 patients besides saving some coin. It seems like they would save money in the long run by just approving it so their patients can better manage their diabetes and have less (expensive) complications in the future.

    I am going to talk to my Endo & pump specialist on Monday to see about appealing this decision. If my insurance company still denies it then I might try contacting Dexcom directly to see if they have some kind of cost reduction plan. Worst case scenario I just pony up the cash to pay for the whole thing myself.

    Though, unlike your experience, my insurance had no problem covering a glucagon kit.

    Has anyone else had this problem with insurance denying your CGM request? If so, what did you do?

    Thanks,

    Joel

  • #120576
  • I too am late answering this post – unfortunately you do have to replace the glucagon kit every year when it expires (and yes it is crazy expensive). One thing I have found is if you keep glucose gel (even cake frosting would work) those are very fast acting carbs and can be rubbed on your gums if you are not responsive with out your need to swallow or choke.
    As far as a CGM request – My doctor had me wear a blind CGM from his office for 2 weeks and submitted the data – got my CGM approved with no problem when he was able to show the variablility with my blood sugars and lows that I was not even aware of at night.
    Hope that helps.

  • #120952
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