Ready-to-Use Glucagon in the Sierras

Last summer I was hiking the High Sierra Trail with my mom and a close family friend, who also lived with Type 1. It was day four of our ten day trek, and I had been battling a string of persistent lows. Despite careful planning and carrying more than enough low snacks, I had already used up nearly double the amount of snacks I had allotted per day. I was tired of stopping, tired of eating, and feeling defeated from having to deal with so many lows. Clearly my body was working so hard that the carbs weren’t able to keep my blood sugar up. Every few miles, I’d go low again, and it was slowing down our whole group. I was sick of dried fruit, sick of gels, and sick of Shot Bloks. 

We still had at least four miles left to go before camp, and we’d already been hiking for over six hours. I knew I needed to try something different. After talking it through with my mom and dia-buddy, we decided it was time to bring out the ready-to-use glucagon. We found a quiet spot just off the trail and took a break. My blood sugar was in the 40s, and I was shaky, sweaty, and nauseous—my typical low symptoms, but layered with extra exhaustion and frustration. I knew this wasn’t a moment for more sugar; I needed to stop the cycle and reset. 

I took out my GVOKE HypoPen® and injected it into my upper arm. It stung pretty bad and felt comparable to a bee sting but the pain faded within a few minutes. Alongside the ready-to-use glucagon, I ate a Clif Bar, hoping that more complex carbs would provide longer-lasting stability once the medication kicked in. Within ten minutes, I was already feeling much better, though still slightly nauseous. After another twenty minutes, I was feeling good and ready to hike again. We hiked the remaining 4 miles over three hours and made it to camp that night without any more hypos. And while I was beyond grateful to have had ready-to-use glucagon in my pack, I was even more thankful to have had people around me who understood and supported my decision. 

I’ve always carried glucagon with me. Around town, I usually bring Baqsimi in my purse, and for longer or more intense trips, I carry GVOKE HypoPen®. It’s a tool I think every person with diabetes should have, and more importantly, should feel empowered to use. In hindsight, could I have treated that low with glucose? Probably. But it wasn’t just a single low—it was hours of lows, and ready-to-use glucagon was what changed the trajectory of that day. 

A huge part of my confidence in using ready-to-use glucagon comes from my experience working with Diabetes Youth Families, a non-profit that runs a diabetes summer camp. There, I’ve seen glucagon used regularly—sometimes in mini-doses for stubborn lows, and sometimes in true emergencies. At camp, glucagon is seen as a tool and part of management in the same way you see other items like ketone meters and insulin pens. 

That mindset carried into my work with the Humboldt chapter of The Diabetes Link, where I’ve had the opportunity to teach peers about glucagon. It’s been eye-opening to realize how many people didn’t know there were multiple forms, both injectable and inhalable, with ready-to-use glucagon being ideal. Others also didn’t know that it could be used outside of cases of unconsciousness. This made it clear to me that glucagon education is still lacking in many areas. 

I think a big part of the problem is that glucagon is often framed as an “extreme emergency-only” medication in diabetes education. That kind of messaging can make people hesitant to use it. Even in that moment on the trail, I found myself wondering, “Is glucagon really necessary? And I’m still conscious and I’ve been this low before—maybe I should just push through.” But the truth is, using glucagon doesn’t mean you’ve failed. It means you know your body, and you’re making a smart decision.

All in all, I am proud about how I managed my diabetes that day. I leaned on my support system and knowledge that I had gained from camp, endos, and other type ones. If I could say one thing to someone with diabetes who feels fear or shame about using glucagon, it would be this: glucagon is just a tool. Using it doesn’t mean you’ve done something wrong—it means you’re taking care of yourself. Sometimes the strongest and smartest choice is the one that resets the day.

This resource is supported by Xeris Pharmaceuticals, Vertex Pharmaceuticals, and Dexcom. The Diabetes Link maintains editorial control over content.