Table 4.

Nasal Glucagon and Injectable Glucagon Administration by Caregivers and Acquaintances

	Caregivers (N = 16)			Acquaintances (N = 15)
Parameters	Nasal glucagon	Injectable glucagon	P	Nasal glucagon	Injectable glucagon	P	Root causes of errors
Delivered a full dose, n (%)a	15 (94)	2 (13)	<0.001	14 (93)	0 (0)	<0.001
Delivered a partial dose, n (%); (min, max% of full dose delivered)	0 (0); —	6 (38); (3%, 85%)	0.018	0 (0); —	3 (20); (36%, 56%)	>0.999	• Did not draw entire solution into syringe from vial
							• Did not completely empty syringe when injecting
							• Powdered glucagon was not completely dissolved
Delivered no glucagon, n (%)	1 (6)	8 (50)	0.016	1 (7)	12 (80)	<0.001	For injectable glucagon: • Injected diluent, bent needle, used insulin instead; injected with empty syringe, refused to attempt injection
							For nasal glucagon: • Did not completely depress plunger
Use of insulin
Used insulin instead of glucagon, n (%)b	0 (0)	2 (13)	0.484	0 (0)	1 (7)	>0.999	• Confused insulin and injectable glucagon
Deliberately used both insulin and glucagon, n (%)	2 (13)	0 (0)	0.484	0 (0)	0 (0)	NA	• Believed insulin was always helpful to people with diabetes
Intended to administer insulin, but administered glucagon instead, n (%)	0 (0)	1 (6)	>0.999	0 (0)	0 (0)	NA	• Believed insulin was the correct treatment, but switched to injectable glucagon because he bent the needle on the insulin syringe
Injected insulin to treat hypoglycemic event	0 (0)	2 (13)	0.484	0	0	NA	• Believed insulin was always helpful to people with diabetes
Mean time to deliver glucagon, minutesc (minimum, maximum)	0.27 (0.03, 0.93)	1.89 (1.3, 2.75)	—d	0.44 (0.17, 0.78)	2.40 (1.3, 3.93)	—d

^aFull dose of NG is delivered when plunger is fully depressed; full dose for injectable glucagon is defined as at least 90% of the targeted 1 mg dose administered.

^bThese participants tried to inject insulin instead of using the supplied glucagon delivery system. They are also included in the count above participants who delivered no glucagon.

^cIncludes data only from simulations in which full or partial glucagon doses were administered.

^dP-values were not provided for mean time to deliver glucagon because only eight caregivers and three acquaintances had timing data available for injectable glucagon.