Health Promotion and Maintenance Q 70
A newly diagnosed 8-year-old child with type I diabetes mellitus and his mother are receiving diabetes education prior to discharge. The physician has prescribed Glucagon for emergency use. The mother asks the purpose of this medication. Which of the following statements by the nurse is correct?
A. Glucagon enhances the effect of insulin in case the blood sugar remains high one hour after injection.
B. Glucagon treats hypoglycemia resulting from insulin overdose.
C. Glucagon treats lipoatrophy from insulin injections.
D. Glucagon prolongs the effect of insulin, allowing fewer injections.
Correct Answer: B. Glucagon treats hypoglycemia resulting from insulin overdose.
Glucagon is given to treat insulin overdose in an unresponsive patient. Patients with decreased levels of consciousness cannot safely consume the oral carbohydrates needed to raise their blood sugar without risk of aspiration, and obtaining IV access can be problematic in the diabetic population, which can prevent prompt administration of IV glucose.
Option A: Following Glucagon administration, the patient should respond within 15-20 minutes at which time oral carbohydrates should be given. Similar to epinephrine auto-injectors, a pre-filled glucagon injector has received approval, which injects into the patient’s thigh. Healthcare providers will most often encounter the emergency kit formulation necessitating reconstitution before injecting the medication, but the intranasal spray may be encountered with increasing frequency in hypoglycemia kits for layperson use.
Option C: Lipoatrophy refers to the effect of repeated insulin injections on subcutaneous fat. Lipoatrophies are considered an adverse immunological side effect of insulin therapy, and in some cases they are mediated by a local high production of tumor necrosis factor-?, which leads to a dedifferentiation of adipocytes in the subcutaneous tissue.
Option D: Glucagon reverses rather than enhances or prolongs the effects of insulin. Glucagon is a reliable method of raising the patient’s glucose and relieving severe hypoglycemia long enough for more definitive correction of the patient’s glucose levels by mouth, particularly when IV access is unavailable to the provider or has failed.