Assess emergency supplies availability
STEP 1 — Gather Information
Document the patient’s current emergency supplies: glucagon kit (or nasal glucagon), ketone strips, backup insulin (vials/pens), syringe or pen needles, pump infusion sets/reservoirs, and expiration dates. Ask about storage conditions and whether the patient knows how to administer glucagon.
STEP 2 — Rule In / Rule Out
If glucagon (kit or nasal) AND backup insulin are present and not expired, proceed to classification; otherwise, flag missing or expired supplies and move to address deficiencies.
STEP 3 — Classify or Stratify
Categorize emergency supply adequacy: Adequate (≥2 of glucagon, ketone strips, backup insulin), Partial (1 item present), or None (0 items present).
STEP 4 — Decide
- Adequate: Reinforce education on storage and use; document plan.
- Partial: Provide missing items, educate on their use, and update back‑up plan.
- None: Arrange immediate provision of glucagon, ketone strips, and backup insulin; train patient/caregiver on administration; establish a clear back‑up plan for pump failure.
Clinical Guardrails / Mimics / Pitfalls
Do not rely solely on patient self‑report without verifying expiration dates and storage conditions. Do not assume the patient knows how to mix or administer glucagon without demonstration. Do not overlook the need for ketone strips in pump users at risk for DKA. Avoid prescribing backup insulin without confirming the patient has appropriate syringes or pens.
Concrete Clinical Example
A 24‑year‑old on CSII reports having a glucagon kit but is unsure of the expiration date. Assessment reveals the kit expired 8 months ago and ketone strips are missing. The clinician provides a new glucagon kit, ketone strips, and backup insulin, demonstrates glucagon administration, and documents a back‑up plan for pump failure.
Source: Diabetes Technology—Continuous Subcutaneous Infusion Therapy and Continuous Glucose Monitoring in Adults: An Endocrine Society Clinical Practice Guideline, Endocrine Society, 2016, DOI:10.1210/jc.2016-2534