Glucagon: Prehospital therapy for hypoglycemia

Abstract

Study objective: This study evaluated the efficacy of glucagon for prehospital therapy of hypoglycemia in patients without IV access. Design: Prospective clinical trial. Setting: Prehospital in a busy, urban emergency medical services system. Type of participants: Fifty consecutive patients presenting with documented hypoglycemia (ChemStrip BG® < 80 mg/dL) and symptoms of decreased level of consciousness, syncope, or seizure were enrolled. Measures and main results: Data collected included pretreatment (ChemStrip BG®) and post-treatment serum glucose (hospital assay) as well as assessment of level of consciousness by a quantitative measure, the Glasgow Coma Score, and by a qualitative scale (0 to 3). The mean pretreatment blood glucose of 33.2 ± 23.3 mg/dL increased after treatment to 133.3 ± 57.3 mg/dL. Qualitative level of consciousness increased from a mean of 1.26 ± .96 to 2.42 ± .94 and Glasgow Coma Score increased from a mean of 9.0 ± 4.19 to 13.04 ± 3.68. The mean time until response was 8.8 minutes in those who responded to both level of consciousness criteria 82% (41 of 50). Glucagon administered for hypoglycemia resulted in a glucose increase in 98% (49 of 50) with headache as the only side effect noted in 4% (two of 50) of patients (P < .0001). Conclusion: Glucagon is safe and effective therapy for hypoglycemia in the prehospital setting. © 1991 American College of Emergency Physicians.