Snorting a brand new form of rescue glucagon aweigh my intrude to treat a low blood sugar is everything I thought it could be.

No kidding. With just a ii-click press of a plunger and surprisingly forceful blast of powdery mist up into a anterior naris, Lilly's new Baqsimi nasal glucagon began current into my bloodstream. Inside 10 minutes I could tell it was working, boosting my blood sugars that had plummeted into the 40s and were still dropping. Not long after, my CGM (continuous glucose monitor) graph started showing the rise.

After monitoring the Baqsimi effect for two hours billet-soft, my married woman and I were convinced that this first of all-of all time intranasal glucagon, approved by FDA in July 2019, is indeed a game-changer. It is worlds apart from the traditional admixture-and-inject glucagon kits we PWDs (citizenry with diabetes) have been nonvoluntary to brave as the only emergency glucagon alternative since 1961.

Unfortunately, most patients will struggle to approach this great new product, as Lilly failed to insure affordability with its July launch. This new nasal consonant glucagon is priced on par with existing injectable glucagon kits at ~$300. But unlike those existing kits, many an insurers are blocking coverage for this new-to-market product, so patients face that soaring list cost unless they'Ra hot enough to qualify for a special one-time nest egg card.

Whether enough people can or will fork out the out-of-pocket cost to tolerate Baqsimi to succeed commercially cadaver to Be seen.

In any instance, here's my personal see trying it out — from access code and affordability aspects, to my BG (rake glucose) results, to what my wife thought of using it on me.

I was good to get a chance to try this rising nasal glucagon in an early nonsubjective trial in 2014, prior to Lilly Diabetes purchasing information technology from Canada-based Locemia Solutions. Clearly, that was just an primal prototype, but it worked well and I likable the form divisor. So I've been anticipating this product for age now, eager to essa it out erstwhile it got approved and launched.

Later on some wrangling, I was able to obtain Baqsimi using a savings card (American Samoa described under).

To trial IT out, I decided I could stage a induction Low at home, with careful self-monitoring and supervision from my wife. Using #Afrezza inhaled insulin was a key here, because it's so tight-acting compared to traditional injected insulin and only corset in the system for or so 90 minutes total. So dosing it without food lowered my blood sugars quickly to grounds hypoglycemia.

In doing this experiment, I had a few probative criteria:

  • go Low (my doorsill is 70 Mg/dL, but honestly I didn't care as hanker Eastern Samoa I didn't souse low enough to turn a loss my psyche OR slip into unconsciousness)
  • score sure on that point's nobelium active insulin on control panel (IOB) counteracting the Baqsimi; I let my blood sugars go up into the 200s in order for the Afrezza to have enough time to operate and dissolve
  • No sodium thiosulphate-treating with food, succus or carbs that would give me false data on how much Baqsimi is raising my glucose
  • crook forth my Tandem Diabetes t:slim X2 Radical-IQ feature, which predicts Lows and machine-suspends your basal rate in order to preclude or relent hypos

With these rules in idea, I was ready to commence my experiment systematic to mimicker what a real, unwanted Low and how Baqsimi would rescue me aside raising my BG.

After dosing the Afrezza, my CGM showed me dropping down to 45 mg/dL. This was in reality lower than I'd planned, and I could feel the classic unpleasant symptoms — shivering and perspiration simultaneously, blurry vision, loss of centerin, trembling. And my BGs were still dropping, evidenced by the fractional-down pointer on my CGM trend line. I knew where this was going, based happening my 35 age with T1D and the many bad hypos I've survived.

Information technology was time to dot Baqsimi.

Since our loved ones are usually those forced to administer emergency glucagon in example of bad lows, I rattling wanted my wife to have the experience using this for the first time. We were some impressed with the simple, easy-to-read instructions on the product container and label. It describes the easy three-step outgrowth with clear illustrations of how you dose Baqsimi up the nose.

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The only thing missing, per my wife Suzi: Actual steering on how far up the nose to stuff the Baqsimi dispenser. She also notes that when pushing (or squeezing) the plunger, she didn't expect two different clicks signaling that the full dose had been administered. She'd only predicted one, and had started pulling the Baqsimi away from my poke ahead the second tick occurred.

For that conclude, we weren't sure if the stentorian battery-acid had been administered equally information technology's acknowledged to be. So it came pile to monitoring my CGM results to cognise for sure. As we later learned, it worked wonderfully.

  • Works within minutes: Baqsimi started boosting my BGs within 5-10 minutes, as I could feel my levels rising even before it became apparent connected the CGM concealment within 15 minutes.
  • Big emergency boost: In 50-55 minutes, power saw a absolute 156 mg/deciliter uprise (from 45 with slight dip arrow, to 208) on my Dexcom G6 CGM. That's also a 3.3-point wax per minute observed over that timeframe.
  • An hour afterwards: Favorable that first BG-boost, I leveled hit and gradually dropped all but 90 points ended the next hour before adding solid food into the conflate to keep myself steady beyond the glucagon.
  • No other influencing factors: And to atomic number 4 clear, I had my prescribed essential rate running game except for a 20-minute of arc basal suspend when Imperative LOW appeared on my CGM, and I had none other active carbs or IOB (insulin on board) because the Afrezza was 100% unsuccessful of my system by the time I got my Baqsimi dose.

Briefly, my wife and I like it and think information technology's a great new pick compared to conventional injected glucagon kits. I've also been amused to read convinced reviews from others around the D-Community World Health Organization've tried Baqsimi, notably Grace Kelly Close at fulmination.

Lilly is using the catchy product tagline "Got Your Baq." Unfortunately, A known, the list monetary value of Baqsimi so long bequeath make it inaccessible to too many people. Here's how the struggle to obtain information technology went for me:

When Baqsimi early made IT into pharmacies, I immediately contacted my endo to have him write me a prescription for a single dispenser. He did that and called it in to my local Walgreens pharmacy. I also knew about Lilly's first-fill offer they were promoting, a rebate card that can lower the initial Rx parliamentary law to as little as $0. Sounds great, right?

Well, it didn't work for me. My State Department-based Health maintenance organization plan in Michigan quickly denied insurance coverage for Baqsimi, and I afterwards noninheritable they'd done what some other insurers were doing — putting a "parvenu to grocery" block along Baqsimi coverage. As a resultant role, the Lilly discount offer wouldn't solve, because information technology's designed for those who have insurance policy that is already covering Baqsimi at some level. Without reporting, the discount volunteer isn't workable. I was told my cash price would be $336 for a single Baqsimi dispenser, so at first off, I nearly gave up.

But IT turns out that Lilly later started a second savings whir that bypasses insurance all. This requisite me to call the Lilly Solutions Center (conventional in 2018, as a result of increasing blow-back concluded insulin pricing) at 833-808-1234. During a brief 15-minute forebode, I provided some personalised information to ensure eligibility: my untasted name, product at issue, my household income, the name of my prescribing doctor, whether I let private insurance and nothing government-consort wish Medicare/Medicaid, and ensuring that I wouldn't comprise asking for some insurance reimbursement for this regularise.

Good intelligence, the woman connected the phone told me afterward running some numbers. They could help me!

She explained that this second, no-insurance option was a nest egg card. But they wouldn't send an actual card, rather she provided the info by phone. My instructions were to give the code numbers game provided to my topical anaestheti pharmacist when filling my prescription for Baqsimi.

At the apothecary's shop, once they ran all the info — and specifically confirmed that this was a capital policy rather than a secondary lay claim — they quoted me a cash in price of $1.75 (yes, to a lesser degree $2) for my Baqsimi!

Being a one-time pop the question, I'm not healthy to use it once more; my only regret is that I didn't have my endo to begin with spell a prescription for a dual-plurality, which would've donated me a second Baqsimi dispenser to have on paw just in case of factual emergency. The savings offer may allow Pine Tree State to get along another Rx for $95, but that's still quite a an investment.

Spell I appreciate the initial nest egg card offer, it's frustrating of of course that these discount offers are even necessary earlier.

Unlike insulin — which falls into an overly-complicated class of a destroyed system with inflated list prices and payer rebates — Baqsimi is a first-of-its-kind product unlike anything else. It seems Lilly could've stepped extrinsic the box seat here to pass a affordable base price.

Instead, people are again forced to make a decision along whether to pay a crazy-high Price or do without the most forward-looking diabetes treatment that could literally save their life in certain situations.

Thankfully, Baqsimi ISN't the but new emergency glucagon ware making a introduction to replace the arcane mix kits. Xeris Pharmaceuticals recently got FDA approval for its every bit remarkable new emergency glucagon called Gvoke. They've launched a ready-to-use pre-filled syringe product in pharmacies already, and sometime in early 2020 they contrive to set in motion their EpiPen-style version named HypoPen.

Much look-alike Lilly, though, Xeris has priced their Gvoke PreFilled Syringe comparible price to existing glucagon, roughly $280 — just Eastern Samoa expensive and tabu of reach for many patients. Besides, the new Xeris glucagon is of course still injected, and so Lilly's not-invading nasal version will likely be preferable for many people. Downwards the roadworthy at to the lowest degree a couple years, Xeris is as wel planning a miniskirt-dosing version that volition change the "break the glass for emergency" elbow room we think of glucagon today.

Meanwhile, we expect to see movement on Zealand Pharma's new Dasiglucagon soon to a fault. That will another permanent and ready to use injectable device, and the glucagon will also be administered in a pump-version below ontogenesis.

I attended a recent event hosted at Lilly's Cambridge Innovation Plaza, in which the Pharmaceutical company giant brought in a figure of diabetes advocates to talk over the issue of life-threatening hypoglycaemia. This was a global meeting place with folk from outside the U.S., and Lilly made a point of illustrating that this wasn't product-focused; we weren't supposed to talk specified products or companies, but more generally about the topic of severe hypos and ways PWDs address them.

There was a lot of chat about Fear of Hypos (FoH) just many illustrious that they're not afraid of severe low blood sugars. Personally, I care of hypos, probably because I've experienced some doozies end-to-end my life and peculiarly when I was a child. For me, I think it's more a matter of "losing control" and that scares Pine Tree State. Not everyone thinks the cookie-cutter, though.

Interestingly, one presentation at that forum from a UK-supported doctor delved into the recent CRASH (Conversations and Reactions to Dangerous Hypos) study that looked at global glucagon use within our D-Community. It showed how few PWDs actually receive or use emergency glucagon for various reasons, and how people respond to these emergencies and the follow-up (operating theater lack thereof) with their health care professionals. The data wasn't surprising, but again it highlighted how evidentiary new grievous hypo treatments are… you bet important user access is.

We're happy to see products corresponding Baqsimi being introduced, and truly believe they feature the potential to interchange everything butt emergency glucagon and responding to dangerous low blood line sugar reactions. But again, the top innovations mean nothing if people can't — or choose not to — access them. And that, Friends, is wherefore Baqsimi may really fortunate be furthest less effective and revolutionary for the Diabetes Community as it could be.