Glucagon for hypoglycaemia treatment in type 1 diabetes

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningfagfællebedømt

To achieve strict glycaemic control and avoid chronic diabetes complications, individuals with type 1 diabetes (T1D) are recommended to follow an intensive insulin regimen. However, the risk and fear of hypoglycaemia often prevent individuals from achieving the treatment goals. Apart from early insulin suspension in insulin pump users, carbohydrate ingestion is the only option for preventing and treating non-severe hypoglycaemic events. These rescue treatments may give extra calories and cause overweight. As an alternative, the use of low-dose glucagon to counter hypoglycaemia has been proposed as a tool to raise glucose concentrations without adding extra calories. Previously, the commercially available glucagon formulations required reconstitution from powder to a solution before being injected subcutaneously or intramuscularly—making it practical only for treating severe hypoglycaemia. Several companies have developed more stable formulations that do not require the time-consuming reconstitution process before use. As well as treating severe hypoglycaemia, non-severe and impending hypoglycaemia can also be treated with lower doses of glucagon. Once available, low-dose glucagon can be either delivered manually, as an injection, or automatically, by an infusion pump. This review focuses on the role and perspectives of using glucagon to treat and prevent hypoglycaemia in T1D.

OriginalsprogEngelsk
Artikelnummere3409
TidsskriftDiabetes/Metabolism Research and Reviews
Vol/bind37
Udgave nummer5
ISSN1520-7552
DOI
StatusUdgivet - 2021

Bibliografisk note

Funding Information:
The authors thank Carol Bang‐Christensen for proofreading the final manuscript. This work was funded by a research grant from Danish Diabetes Association and from the Danish Diabetes Academy supported by the Novo Nordisk Foundation.

Funding Information:
Ajenthen G. Ranjan, Signe Schmidt, and Kirsten Nørgaard have a patent in methods and medical uses relating to the treatment of hypoglycaemia (WO2019008033). Ajenthen G. Ranjan received a postdoc fellowship from the Danish Diabetes Academy supported by the Novo Nordisk Foundation and received a research grant from the Danish Diabetes Association. Kirsten Nørgaard has served as an adviser for Medtronic, Abbott, and Novo Nordisk; owns stocks in Novo Nordisk; has received research grants from Novo Nordisk, Medtronic, Zealand Pharma, and Roche; and has received fees for speaking from Medtronic, Roche, Rubin Medical, Sanofi, Zealand Pharma and Novo Nordisk. Signe Schmidt has served as an adviser for Medtronic.

Publisher Copyright:
© 2020 John Wiley & Sons Ltd.

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