Low blood sugar An injectable form of glucagon may be part of first aid in cases of
low blood sugar when the person is unconscious or for other reasons cannot take glucose orally or by intravenous. The glucagon is given by intramuscular, intravenous or subcutaneous injection, and quickly raises
blood glucose levels. To use the injectable form, it must be reconstituted prior to use, a step that requires a sterile diluent to be injected into a vial containing powdered glucagon, because the hormone is highly unstable when dissolved in solution. When dissolved in a fluid state, glucagon can form amyloid fibrils, or tightly woven chains of proteins made up of the individual glucagon peptides, and once glucagon begins to fibrilize, it becomes useless when injected, as the glucagon cannot be absorbed and used by the body. The reconstitution process makes using glucagon cumbersome, although there are a number of products now in development from a number of companies that aim to make the product easier to use.
Beta blocker overdose Anecdotal evidence suggests a benefit of higher doses of glucagon in the treatment of overdose with
beta blockers; the likely mechanism of action is the increase of cAMP in the
myocardium, in effect bypassing the
β-adrenergic second messenger system.
Anaphylaxis Some people who have
anaphylaxis and are on beta blockers are resistant to
epinephrine.