People usually first notice an abnormality of glucagon secretion when blood sugar swings don’t match meals or insulin use—such as unexpected low blood sugar (hypoglycemia) with shakiness, sweating, confusion, or, less often, stubborn high sugars that don’t respond as expected. Doctors often pick it up during diabetes care when fasting or overnight glucose is unusually low, A1C doesn’t line up with home readings, or lab tests show inappropriately high or low glucagon levels compared with glucose. In rare cases, a glucagon‑producing tumor (glucagonoma) is first suspected because of weight loss, a distinct reddish rash, mouth sores, and diabetes developing together—classic “first signs of abnormality of glucagon secretion” that prompt testing.