Injectable glucagon (IG) is challenging to use for caregivers of a person with diabetes (PWD) in stressful severe hypoglycemia (SH) rescue. We evaluated user preference for nasal glucagon (NG) and IG devices after treating simulated SH. The PWD trained arm was adult PWDs trained to use NG or IG, then PWDs trained their caregivers how to use it; 1 week later, caregivers administered the device to a life-like manikin exhibiting SH in a simulated real life setting with distractions creating urgency. The untrained arm was adults not associated with a PWD, but willing to assist - not trained, but shown the device just presimulation. After 1 week, the process was repeated with the other device. We assessed perceptions of simulation participants and PWDs via comparative device questionnaires, completed after videos of both simulations were viewed after the 2nd simulation (no confirmation of success provided). NG was rated more preferred by those with successful doses of NG or IG. PWDs indicated that they felt safer with NG even with successful IG dosing (Table). Untrained users were as successful as PWD-trained in dosing NG, while there were no IG successes without training. None of the few who preferred IG gave a successful IG dose, whereas the few successful IG-users preferred NG or stated no preference. Being PWD-trained was not critical for success with NG, and ease of preparation and use likely contributed to overall preference.


J. Settles: Employee; Self; Eli Lilly and Company. C.J. Child: Employee; Self; Eli Lilly and Company. Stock/Shareholder; Self; Eli Lilly and Company. S.K. Bajpai: Employee; Self; Eli Lilly and Company. E. Spaepen: Consultant; Self; Eli Lilly and Company. J.G. Suico: Employee; Self; Eli Lilly and Company.


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