New Diabetes Guidelines: Do You Have The Right Tools For Very Low Blood Sugar?

Do You Have the Right Tools for Very Low Blood Sugar?

If you or a loved one has diabetes, you know how important it is to keep blood sugar levels in a healthy range. But even when you’re carefully watching your diet, taking medications as prescribed, and checking your blood sugar levels regularly, low blood sugar can still occur. Very low blood sugar is unpredictable and can be dangerous — even life-threatening.

That’s why it’s important to be informed about the latest guidelines from the American Diabetes Association (ADA). The new recommendations say that people taking insulin or who are at high risk of low blood sugar should have a prescription for glucagon – preferably ready-to-use glucagon – like Gvoke HypoPen® (glucagon injection), the ready-to-use rescue pen for low blood sugar emergencies.

Who’s at High Risk for Hypoglycemia?

The guidelines say that people who take insulin, sulfonylureas, or meglitinides are at increased risk for very low blood sugar. If that’s you or someone you care for, it’s time to talk to your healthcare provider about your risk.

What Is Glucagon?

Glucagon is a hormone produced in the pancreas that stimulates the liver to release stored glucose into the bloodstream when your blood sugar levels are too low. Glucagon is also available as a prescription medication and is used to treat people with diabetes who experience very low blood sugar.

What Do the Guidelines Say about Glucagon?

The new guidelines recommend that individuals taking insulin or at high risk for low blood sugar should have a prescription for ready-to-use glucagon. Premixed options allow for quick and simple administration for you or for those around you who are in a low blood sugar emergency. It also can provide peace of mind for you and your loved ones when it comes to being ready to treat very low blood sugar.

How to Ensure Your Diabetes Management Plan Aligns with the Current Guidelines:

Use the checklist below to make sure you are prepared for the unexpected.

  1. Revisit your emergency plans and toolkit: Take a fresh look at your low blood sugar emergency plan and diabetes toolkit. Your diabetes toolkit should have glucose tablets or gel, candy, juice, and ready-to-use glucagon.
  2. Learn about options like Gvoke HypoPen®, the ready-to-use rescue pen for low blood sugar emergencies. Ask your doctor about your risk, and if Gvoke HypoPen is right for you.
  3. Get a prescription for ready-to-use glucagon and fill it right away. Always keep it with you.
  4. Ensure you know when to use ready-to-use glucagon:
    • If correcting with food or drink isn’t working
    • If you’re unable to swallow safely
    • If you feel like passing out*, if you pass out, or if you have a seizure
  5. Educate friends, family, and coworkers about the signs and symptoms of low blood sugar and what they can do to support you should a low blood sugar emergency occur. That includes knowing where to find your ready-to-use glucagon and how and when to use it.

Given the latest guideline updates, having ready-to-use glucagon is no longer just a suggestion, but an essential tool for people on insulin or who are at high risk for low blood sugar. You deserve to feel equipped, supported, and empowered in your diabetes management by having a safety net for when you need it most and being prepared to treat very low blood sugar no matter what.

Talk to your doctor today about risk factors for very low blood sugar and include Gvoke HypoPen® in your diabetes toolkit to align with the latest guidance.

*Ready-to-use glucagon can be used even before you or the person you’re helping passes out or has a seizure.

Editor’s Note: Xeris Pharmaceuticals is a partner of Taking Control of Your Diabetes®. TCOYD® maintains control over all editorial content. Please consult your healthcare team before making any changes to your diabetes care regimen.


GVOKE is a prescription medicine used to treat very low blood sugar (severe hypoglycemia) in adults and kids with diabetes ages 2 years and above. It is not known if GVOKE is safe and effective in children under 2 years of age.


Do not use GVOKE if:

  • you have a tumor in the gland on top of your kidneys (adrenal gland), called a pheochromocytoma.
  • you have a tumor in your pancreas called an insulinoma.
  • you are allergic to glucagon or any other inactive ingredient in GVOKE.


High blood pressure. GVOKE can cause high blood pressure in certain people with tumors in their adrenal glands.

Low blood sugar. GVOKE can cause low blood sugar in certain people with tumors in their pancreas called insulinomas by making too much insulin in their bodies.

Serious allergic reaction. Call your doctor or get medical help right away if you have a serious allergic reaction including:

  • rash
  • difficulty breathing
  • low blood pressure


The most common side effects of GVOKE in adults include:

  • nausea
  • vomiting
  • swelling at the injection site
  • headache

The most common side effects of GVOKE in children include:

  • nausea
  • low blood sugar
  • high blood sugar
  • vomiting
  • abdominal pain
  • headache
  • pain or redness at the injection site
  • itching

These are not all the possible side effects of GVOKE. For more information, ask your doctor.
Call your doctor for medical advice about side effects. You are encouraged to report side effects of prescription drugs to the FDA. Visit, or call 1-800-FDA-1088.


Before using GVOKE, tell your doctor about all your medical conditions, including if you:

  • have adrenal gland problems
  • have a tumor in your pancreas
  • have not had food or water for a long time (prolonged fasting or starvation)
  • have low blood sugar that does not go away (chronic hypoglycemia)
  • are pregnant or plan to become pregnant
  • are breastfeeding or plan to breastfeed

Tell your doctor about all the medicines you take, including prescription and over-the-counter medicines, vitamins, and herbal supplements.


  • Read the detailed Instructions for Use that come with GVOKE.
  • Use GVOKE exactly how your healthcare provider tells you to use it
  • Make sure your relatives, close friends, and caregivers know where you store GVOKE and how to use it the right waybefore you need their help.
  • Act quickly. Having very low blood sugar for a period of time may be harmful.
  • Your healthcare provider will tell you how and when to use GVOKE.
  • After giving GVOKE, your caregiver should call for emergency medical help right away.
  • If you do not respond after 15 minutes, your caregiver may give you another dose, if available. Tell your healthcare provider each time you use GVOKE. Low blood sugar may happen again after receiving an injection of GVOKE. Your diabetes medicine may need to be changed.


  • Keep GVOKE in the foil pouch until you are ready to use it.
  • Store GVOKE at temperatures between 68°F and 77°F.
  • Do not keep it in the refrigerator or let it freeze.

Keep GVOKE and all medicines out of the reach of children.

For more information, call 1-877-937-4737 or go to

Please see the Full Prescribing Information for Gvoke


  1. Avatar

    Regarding the use of GVOKE if you have adrenal gland problems, specifically, Adrenal Insufficiency:
    Could you please expound on this? Also, is there a preferred glucagon product that is safer for those with Adrenal Insufficiency? thank you for any information you can supply.

    • Avatar

      Hi Roseanne,

      Thanks so much for your question. If you have adrenal insufficiency, it would be best for you to discuss the use of glucagon with your healthcare team. For Gvoke and all other forms of glucagon, concerns with adrenal insufficiency fall into the “Warnings & Precautions” labeling for all glucagon products. In these situations, the preferred method of treatment is glucose. This is class labeling across all glucagon products.

      Here is the exact wording from the package insert:

      GVOKE is effective in treating hypoglycemia only if sufficient hepatic glycogen is present. Patients in states of starvation, with adrenal insufficiency or chronic hypoglycemia may not have adequate levels of hepatic glycogen for GVOKE administration to be effective. Patients with these conditions should be treated with glucose.

      Again, best for you to speak with your healthcare provider, and good for you for being proactive about this topic.

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