OBJECTIVES : People with diabetes (PTs) on insulin are at risk of severe hypoglycemia (SH), a potentially life-threatening event that requires assistance from others. There is significant unmet medical need to improve successful administration of glucagon by caregivers (CGs) and acquaintances (AQs). This study sought to understand perceptions and preferences for two alternate glucagon delivery devices that are currently in development.

METHODS : Qualitative interviews were conducted with PTs, CGs and AQs from a general population panel. Interviews focused on aspirational device features and perceptions about the two devices, nasal glucagon (NG) and autoinjector glucagon (AI) - visuals of the instructions for use were shown. Verbatim transcripts were developed, and a thematic analysis was performed.

RESULTS : 45 (15 PTs, 15 CGs, and 15 AQs) interviews were conducted. The most frequently spontaneously identified aspirational features for a new glucagon device were ease of use (n=29; 64%), including being uncomplicated, pre-mixed/ready-to-use, and can use quickly; small/easy to carry (n=9; 20%); needle-free/no long needles (n=8; 18%); and easy instructions (n=4; 9%). In general, having a glucagon delivery device on hand would make participants feel prepared, protected and confident that others could assist in the event of SH. More participants across all subgroups preferred NG versus AI (n=33; 73% vs. n=12; 27%). Favorable comments about NG included its ease of use and being needle-free; AI comments included familiarity. There may be more hesitation using AI versus NG because of anxiety about needles and locating an injection site. There was more comfort socially with NG, as it was viewed more discreet and less embarrassing; also, it was considered more child-friendly.

CONCLUSIONS : This research suggests that PTs, CGs and AQs prefer a device that is simple and ready to use. NG was generally preferred over an AI primarily because it is less complicated and is needle-free.