Location: Children's Nutrition Research CenterTitle: Nonaqueous, mini-dose glucagon for treatment of mild hypoglycemia in adults with type 1 diabetes: A dose-seeking study
|HAYMOND, MOREY - Children'S Nutrition Research Center (CNRC)|
|REDONDO, MARIA - Baylor College Of Medicine|
|MCKAY, SIRIPOOM - Baylor College Of Medicine|
|CUMMINS, MARTIN - Xeris Pharmaceuticals|
|NEWSWANGER, BRETT - Xeris Pharmaceuticals|
|KINZELL, JOHN - Xeris Pharmaceuticals|
|PRESTRELSKI, STEVEN - Xeris Pharmaceuticals|
Submitted to: Diabetes Care
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 11/23/2015
Publication Date: 3/1/2016
Citation: Haymond, M.W., Redondo, M.J., Mckay, S., Cummins, M.J., Newswanger, B., Kinzell, J., Prestrelski, S. 2016. Nonaqueous, mini-dose glucagon for treatment of mild hypoglycemia in adults with type 1 diabetes: A dose-seeking study. Diabetes Care. 39(3):465-468.
Interpretive Summary: Patients with type 1 diabetes are required to keep their blood sugars near the normal range but when they do, they frequently experience low blood glucose values and symptoms. The usual form of treatment is oral sugar but many don't like this because it adds extra calories, is slow to raise the blood sugar and frequently causes delayed over shoot of the blood sugar. Glucagon is known to increase the blood but the aqueous preparation is not stable over hours. In this study we tested several small doses of non-aqueous glucagon and found that it was very effective at a dose of 150 microgram to raise the glucose over 15 to 30 minutes. Over time this preparation my become the standard of practice and be used in the new highly advance experiment insulin/glucagon pumps.
Technical Abstract: To evaluate mini-dose glucagon in adults with type 1 diabetes using a stable, liquid, ready-to-use preparation, twelve adults with type 1 diabetes receiving treatment with insulin pumps received subcutaneous doses of 75, 150, and 300 ug of nonaqueous glucagon. Plasma glucose, glucagon, and insulin concentrations were measured. At 180 min, subjects received insulin followed in ~60 min by a second identical dose of glucagon. Mean (+/-SE) fasting glucose concentrations (mg/dL) were 110+/-7, 110+/-10, and 109 +/-9 for the 75-, 150-, and 300-ug doses, respectively, increasing maximally at 60 min by 33, 64, and 95 mg/dL (all P < 0.001). The post–insulin administration glucose concentrations were 70+/-2, 74+/-5, and 70 +/-2 mg/dL, respectively, with maximal increases of 19, 24, and 43 mg/dL post–glucagon administration (P < 0.02) at 45–60 min. Subcutaneous, nonaqueous, ready-to-use G-Pen Mini glucagon may provide an alternative to oral carbohydrates for the management of anticipated, impending, or mild hypoglycemia in adults with type 1 diabetes.