So sorry for the bad pun. Couldn’t help myself. But this is serious stuff, actually. A small company out of Washington state is working hard to gather some much-needed data on severe hypoglycemia, and how we can better prepare for it and treat it.
Apparently there’s not a lot of great existing data on severe hypo cases — in particular on how it typically gets solved when it occurs. (Well, there’s a little)
The core questions this group would like to answer are:
How does severe (emergency) hypoglycemia impact people’s lives?
What types of experiences have people had with the current glucagon hypo-kits?
Is there a better way to deliver glucagon in emergencies?
Photo by C.Benefiel
Dick Rylander, a veteran of Park Davis Pharmaceuticals and Founder of the startup company Enject, tells me he’s worked with the famous Dr. Bill Polonsky to develop two survey forms to help answer these questions. Rylander says he’s also in discussions with the equally renowned Dr. Steven Edelman about authoring a research paper based on the survey data gathered.
If you want to help out, here are the survey links:
Adult Survey (18 and over):
http://www.surveygizmo.com/s/106580/adult-patient-survey
Caregiver Survey:
http://www.surveygizmo.com/s/106642/caregiver-survey
I am told that these take just 10 minutes or less to complete. * Please complete only the survey that fits your situation/role, between now and April 15th 2009.
And in case you’re wondering about Enject’s motives here — yes, they are fundamentally commercial. The company is developing a new type of emergency product to treat severe lows that will be much “less invasive” and easier to use than your typical orange-case-with-big-needle Glucagon Kit. I can’t reveal any more details about the Enject concept at this time, because the company is considering entering their product concept in our 2009 DiabetesMine Design Challenge (!) Keep your eyes peeled for a possible video entry on that one.
I for one am excited about the prospect of “moving the glucagon kit out of the 1950s” — just as another entrepreneur attempted in another innovation competition a few years back — only this time minus the gi-normous needle.
Hmmm…The pen in the video (within the survey) actually looks much harder than a typical glucagon kit. I like the thought that they’re trying to make things better but…I dunno. I don’t think this is the solution.
Glucagon and severe low emergencies are one of my “hot buttons” concerning first-response services. Between the time it takes the local rescue squad to arrive on scene, figure out one is having a severe low (and the patient is not responsive enough to administer glucose tablets/gel/liquid), call for the paramedic (basic EMTs are not licensed to use the patient’s glucometer to check blood glucose levels, nor to administer glucagon), wait for the paramedic to get there and assess the situation…
Shortly after DiabeticConnect went live, one of the active members posted about a situation in which a neighbor of his died due to these delays.
Anything that will allow an EMT-A to revive an unresponsive diabetic quickly, without having to call for the next-level responder… is a Very Important Development in my book.
This was unexpected and may apply equally to diabetics though it was regarding epinephrine kits, i.e., beware and be aware.
AAAAI: Most Physicians Fail EpiPen Test
2 hours ago
WASHINGTON — Among physicians who had prescribed epinephrine injectors, most had not told their patients how to use them, and nearly all were unable to operate one successfully, a small survey showed.
http://www.medpagetoday.com/MeetingCoverage/AAAAIMeeting/13275
I’ll take the humungous needle without complaint if it saves my life — I think this injection has to be IM rather than subcutaneous (insulin is subQ).
The absolute last thing I want is for my glucagon kit to look like anything other than a serious medical device. I don’t want a pink Hello Kitty carrying case or any other design changes.
I have had to use the emergency kit twice. I was completely terrified both times — I administered the shots myself, in one case when my vision was starting to fade and I didn’t have much time before things went dark. I now keep 2 kits on hand at all times, in my purse or next to my bed.
I want my kit to scream “Use in Emergency.” Most health care providers and house-mates of diabetics know what the current standard bright red-orange kit looks like. I’d hate to waste precious seconds having people hunt for an unfamiliar case.
I’m with EJ in that I don’t think the pen looks any simpler than a good old fashioned glucagon kit. Glucagon kits are really straight-forward so any “improvements” probably aren’t going to be anything of significance. I’ve never had to give glucagon to anyone, but I’ve been on the receiving end several times. No one giving it to me complained that it was hard to do. Why fix what ain’t broke?
The real issue is that this is one for the caregivers, most of whom are probably very worried about the person, such as parents Frankly, I don’t think many people care about the size of the needle (that’s the same attitude behind Exubera’s abysmal failure in the marketplace), but the difficulty in reconstituting the product. The reconstitution process of the current kits is very difficult, and I’m not sure this product resolves that fundamental issue.
I’m the mom of a child with diabetes, but I also work in the school health office and I really think a better/easier way of a glucagon injection would be fabulous. I am comfortable giving a shot, but I know many of the people at the school are not as comfortable and would greatly welcome something easier (like the epi-pen). Especially because many schools do not have nurses and just have a trained office worker who would be responsible for the injection.