It wasn’t until July 2013 – from inside of an emergency room – that I first heard of Type 1 diabetes (T1D). Being the first with the disease in my family, we did not understand what challenges we were beginning to face. It was not just about trying to keep your blood sugar down from hyperglycemia, it also involved taking the necessary measures to avoid a hypoglycemia. I did not understand the importance of hypoglycemia management until October 2018. After a hard day’s work of walking around the giant UCSD campus to attend classes, I got dinner and headed back to my dorm. I gave myself insulin for my dinner and waited my standard 15 minutes.
"He explained to me, “It was not easy to focus on following the steps to prepare the glucagon syringe, let alone give a shot, when your friend is having a diabetic seizure. So, I just called the paramedics.”
Waiting 15 minutes before eating was something I was used to doing. This time, however, the outcome was drastically different. Although I completely finished eating, my blood sugar would not stop dropping. To compensate, I drank an entire bottle of soda. Then, I called my parents back home so they could make sure my blood sugar would rise back up to normal range using Dexcom share. At this point, realizing that I was losing study time for my upcoming exams, I opened my books. After reading the first page, my vision became so blurry that I started seeing double. Therefore, I reported back to my parents that I was going to lie down on my bed and rest.
The next thing I remember was “waking up” to a glucose IV and a team of paramedics surrounding my bed that were forcing me to eat glucose tablets. Upon reflecting on what had happened, I found my glucagon kit was opened, but it had been left untouched. I talked with my roommate (who also has diabetes) about what had happened. He told me that he opened the [traditional] glucagon kit, but, because of how nerve-racking the situation was, he refrained from using it. Instead, he waited for the paramedics to arrive and assess the situation. He explained to me, “It was not easy to focus on following the steps to prepare the glucagon syringe, let alone give a shot, when your friend is having a diabetic seizure. So, I just called the paramedics.”
Although trained since the summer of 2017, I have never had to use a glucagon kit on any of my friends with T1D. Given the potentially dire circumstances, I am sure it would be very challenging to do so with the original glucagon kit. It was not until last August that I learned that needle-free, nasal glucagon (Baqsimi®) had been approved by the FDA. After ordering a sample from my endocrinologist, I opened the box and started playing with it. Without even reading the instructions, I already had a general idea of how to use it in case of hypoglycemic shock. I still read the instructions to make sure I would know how to use it correctly, and indeed I was.
"I am fascinated by the degree to which simple product innovations can save a life."
Another severe low treatment option is the Gvoke Hypopen™, an autoinjector unexposed premixed syringe. I found out about this autoinjector option when I was organizing a T1D Workshop at UCSD. Compared the original glucagon kit, all the components are mixed and ready-to-go. Since it is an auto-injector, it hides the needle (sort of like an allergy anaphylaxis pen). In my opinion, this makes it less intimidating for a user when treating a hypoglycemic shock. I am fascinated by the degree to which simple product innovations can save a life. Going from a bulky, non-assembled glucagon kit to a pre-filled glucagon nasal spray or autoinjector pen have served as big step-ups in diabetes treatment options.
The COVID-19 crisis has significantly impacted how I manage my T1D. For instance, I do much less running and working out than I did prior to the stay-at-home orders; this makes my blood sugar low less often. That said, it does not change my way of treating lows. I always keep Baqsimi® next to me at all times in case of a low blood sugar. As we all know, you must be prepared with T1D; you never know what is going to happen.
Even getting my hands on Baqsimi® has been drastically different as a result of the pandemic. The last check-up I had with my endocrinologist was conducted virtually, and we talked profusely about blood sugar management during quarantine. My endocrinologist decided I needed to take additional precautions by always having an extra Baqsimi® dose handy. However, since I am a college student, paying for glucagon medication can be quite challenging. I found and took advantage of the Got Your BAQ® program, which allowed me to pay $25 for a Baqsimi® kit.
Finally, these exciting advances have even helped mold the vision I have for my future educational and professional pursuits. The rapid pace in research for T1D over the past century has motivated me to pursue a career in the diabetes field. I am currently majoring in biochemistry and cell biology with plans on obtaining a PhD in biology. From there, I aim to fulfill one of my longtime dreams: harnessing my knowledge and expertise to help cure T1D.
Editor's note - Visit our Access and Affordability Page to learn about savings programs for medications, including the new glucagon options.