New Haven Register (New Haven, CT)
Low blood sugar emergency
Incident changes college student’s mind about being rescue ready
It was Valentine’s Day weekend when Emily Marcum’s parents traveled from Nevada to New York City to visit their daughter. Emily had always dreamed of living in New York, and that dream came true when she was accepted to study elementary education at Queens College.
On that cold February day, the 19-year-old had planned a full day of sightseeing and walking across the city with her family, starting in Manhattan and stretching across the East River into Brooklyn. She could not wait to share some of New York’s most iconic sights and had planned an ambitious, full-day affair concluding with tickets to see The Phantom of the Opera on Broadway.
But halfway through the family’s city tour, as they walked along the Brooklyn Bridge, Emily, who has type 1 diabetes, started to feel hungry, confused and shakiness throughout her body.
Emily was 12-years-old when she was diagnosed with type 1 diabetes. In the seven years since, she has learned to manage her condition by always paying attention to carbs in meals and monitoring her blood sugar levels. Growing up, Emily and her parents were vigilant about being prepared for very low blood sugar emergencies - a condition people with diabetes may experience if their blood sugar drops low enough that they need help to recover. For the Marcums, being prepared meant having a glucagon prescription on hand and making sure Emily’s closest friends and family understood how to use the treatment, just in case.
But Emily didn’t think she would ever experience a low blood sugar emergency as long as she had candy or cake gel available to help raise her blood sugar level and she didn’t always feel comfortable talking about the possibility one might occur with her friends.
“I ate a few Skittles to try and raise my blood sugar but it wasn’t making me feel any better,” Emily recalls from that day in February. “I told my parents that I had a place in mind for lunch but couldn’t remember where it was anymore. I just needed to stop and sit down.”
By the time Emily and her parents crossed the Brooklyn Bridge, her usual efforts to raise her blood sugar quickly were not working.
“I was holding my mom’s hand and then suddenly felt my head fly back. My mom thought I was joking at first, but my eyes rolled back and she immediately knew something was wrong,” said Emily. “My dad helped lay me on the ground, but I have no memory of that or anything in the moments after.”
Emily was experiencing her first low blood sugar emergency. Luckily, her mom had brought Emily’s Baqsimi® (glucagon) nasal powder 3 mg prescription on the trip and was able to spring into action. She grabbed the Baqsimi from her backpack and quickly administered it to help revive her daughter. Baqsimi is the first and only dry nasal spray that can treat very low blood sugar (severe hypoglycemia) in people with diabetes ages 4 years and above, and is a form of glucagon given as a puff in the nose. Do not use Baqsimi if: you have a tumor in the gland on top of your kidneys (adrenal gland) called pheochromocytoma; you have a tumor in your pancreas called insulinoma; you are allergic to glucagon, or any other ingredient in Baqsimi.
“Before this experience, I didn’t really think or talk much about the possibility of having a low blood sugar event that I couldn’t use candy to recover from. This experience showed me that, despite doing all the right things, the unexpected can still happen,” Emily said.
Emily survived the low blood sugar emergency, but the traumatic experience was a wakeup call. In the months since, Emily brings Baqsimi with her wherever she goes and makes sure her family, friends, and even boss at the coffee shop where she works back home know when and how to use her glucagon rescue treatment.
According to Beth Mitchell, a registered nurse who has treated people with low blood sugar emergencies and is a member of the diabetes team at Eli Lilly and Company, there are a few steps people living with diabetes who are at risk for very low blood sugar can take to prepare for an emergency:
Keep glucagon rescue on hand: Very low blood sugar is an unpredictable event for people with type 1 or type 2 diabetes that can happen unexpectedly, anytime, anywhere. Be prepared by having rescue glucagon readily available. While there are several options to choose from, you may consider Baqsimi, which offers a ready-to-use option. Baqsimi is the first and only dry nasal spray that can treat very low blood sugar in people with diabetes ages 4 years and above. Baqsimi may cause serious side effects including:
Know when and how to use rescue glucagon: Rescue
glucagon is meant to be used when someone is having a low blood sugar emergency, where the person is unable to eat or drink or needs help from someone else. Possible signs of a low blood sugar emergency may include irritability, dizziness, lack of coordination, inattention or confusion, shaking or sweating, and seizure or loss of consciousness. If you choose to have Baqsimi as your rescue glucagon, know that Baqsimi is designed to be given as a puff in the nose and does not need to be inhaled. It can be given even if the recipient is passed out or has nasal congestion. It is important to review the Instructions for Use included with your Baqsimi device, or available on www.baqsimi.com. In addition, Baqsimi is compact, portable and ready to use (no reconstitution or injection required) in a precise and premeasured dose. It requires no refrigeration and can be stored at temperatures up to 86°F (30°C degrees).
Talk your doctor and support network: While some people in your support network may be familiar with how to help in the event of a low blood sugar emergency, reminding them of the possible signs of an emergency and when and how to use rescue glucagon may help them feel confident to help in case the unexpected happens. And don’t forget to talk with your doctor and diabetes care team about how to prevent low blood sugar events, as well as about emergency preparedness.
As Emily and her family learned from her low blood sugar emergency, having a simple to use glucagon rescue treatment on hand is critical, whether you’re at home, heading off to school or out with friends. If you want to feel more prepared and confident in case the unexpected happens, even if you’ve never had a low blood sugar emergency before, be rescue ready and talk to your doctor about what rescue medication option is right for you and your support network.