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Metabolic & endocrine

Glucagon

The body's own counter-insulin hormone, available as approved injection and nasal rescue products — another proof that 'nasal peptide' is not shorthand for experimental.

L5Practice-changingApproved medicineApprovedHigh confidenceLast reviewed 2026-08-23
NasalIMSC injection

Also known as: Baqsimi, Gvoke, glucagon injection

Evidence passport

Last reviewed 2026-08-23

Evidence level
L5Practice-changing
Confidence
High confidence
Human efficacy
88/100
Human safety
85/100
Regulatory status
Approved medicine
Development
Approved
Routes
NasalIMSC injection
Evidence base
Includes human data
Furthest stage
Approved
Source curation
Sources fully curated
Clinical maturity
Long-approved essential rescue medicine, multiple formulations

Overview

Human evidence88/100
Preclinical evidence80/100
Human safety evidence85/100

Clinical maturity: Long-approved essential rescue medicine, multiple formulations

Routes & formulations

Studied / approved routes

NasalIMSC injection

Route genuinely changes the product here: Baqsimi is a single-use nasal powder requiring no injection, while traditional rescue glucagon is an injection (intramuscular or subcutaneous depending on product). Ease of use by untrained caregivers was a major reason the nasal formulation mattered. This entry describes approved products only — no usage instructions.

Route availability is not evidence of efficacy, and evidence from one route does not transfer to another. The Registry never provides dosing or sourcing information.

Peptide lifecycle

  1. Discovery

  2. Preclinical

  3. Phase I

  4. Phase II

  5. Phase III

  6. Approved

Approved

What it is

A 29-amino-acid peptide hormone that raises blood glucose by mobilising hepatic glycogen — the physiological opposite of insulin.

What people claim

  • Rapidly reverses severe hypoglycaemia when the person cannot take oral carbohydrates

What the evidence actually says

One of the longest-established peptide medicines in existence, with efficacy and safety defined across injectable and nasal formulations in their labels.

Human evidence

  • Decades of clinical use plus controlled studies supporting each approved formulation, including nasal bioequivalence work.

Preclinical evidence

  • Foundational endocrinology of the glucagon receptor and hepatic glucose output.

Animal and cell findings are Level 1–2 evidence.

Mechanism and pathways

  • Glucagon-receptor activation in the liver drives glycogenolysis and glucose release.

Safety and unknowns

  • Labelled effects include nausea and vomiting; product-specific instructions and age limits apply.
  • Ineffective when hepatic glycogen is depleted — a labelled limitation, not a dosing matter for this registry.

Cancer relevance

No concern identified

No established human cancer signal; glucagonoma-related physiology is a separate disease context.

Regulatory status

Approved in multiple formulations — injectable glucagon kits and prefilled products, and a dry nasal powder (Baqsimi) — for the treatment of severe hypoglycaemia in people with diabetes. Indications and age ranges differ by product label.

Evidence grade

L5Practice-changingHigh confidence

Replicated large randomised trials, pivotal Phase 3 programmes, or a major regulatory decision.

What would change our rating?

  • Not applicable at this evidence tier.

References and sources

Sources fully curated

Source hierarchy: regulatory documents and trial registries first, peer-reviewed work next, sponsor material flagged as non-independent. We never use supplier or clinic marketing as evidence, and where a verified source has not yet been curated we say so rather than inventing one.

Evidence change history

No recorded changes yet. Baseline position set on 2026-08-23.