How Should I Inject Glucagon?
Novo Nordisk says users should pinch the skin and inject glucagon into the resulting skin fold. The Eli Lilly & Co. instructions say, “Insert the needle into the loose tissue under the cleansed injection site.” And the American Diabetes Association instructs users to “inject glucagon into a large muscle.” Which is correct? Bruce Hedge, Big Lake, Minnesota
Craig Williams, PharmD, responds
Glucagon is an injectable drug used to treat low blood glucose emergencies (when a person is unable to treat a low on his or her own). While it’s important to correctly deliver injectable medications, many can be safely administered via multiple methods.
What to Know
In general, the difference between intravenous (in the vein), intramuscular (in the muscle), and subcutaneous (under the skin) injection is how quickly and completely the medication is absorbed into the blood. The quickest and most complete method is via IV, followed by intramuscular and then subcutaneous.
According to the Food and Drug Administration, glucagon can be safely administered using any of these three methods, though IV delivery is generally reserved for trained health care workers. Glucagon works a tad faster when injected into the muscle versus under the skin, but because the drug is well absorbed with either method, the difference is slight. It is more important to quickly inject the drug in a person who is unconscious from or unable to personally treat a glucose low than to worry about injection method.
The instruction to pinch the skin before injecting glucagon is meant to ensure the medication is injected beneath the skin and not accidentally into the muscle. This recommendation is most often made for thin people who may not have much fat between the skin and the muscle. In the case of glucagon, it doesn’t matter whether the skin is pinched or not prior to administration because the drug is safe and effective when given under the skin or into the muscle.
Glucagon injection methods vary, and all are effective. I generally do not recommend the pinching technique; there is always a small risk the needle could accidentally prick your finger while you pinch the skin and deliver an injection to the person who needs it. Done correctly, however, it is perfectly safe and effective.