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J Clin Endocrinol Metab. 2017 Aug 1;102(8):2994-3001. doi: 10.1210/jc.2017-00591.

Efficacy and Safety of Mini-Dose Glucagon for Treatment of Nonsevere Hypoglycemia in Adults With Type 1 Diabetes.

Author information

1
Baylor College of Medicine, Houston, Texas 77030.
2
Jaeb Center for Health Research, Tampa, Florida 33647.
3
University of Pennsylvania Perelman School of Medicine/Rodebaugh Diabetes Center, Philadelphia, Pennsylvania 19104.
4
Joslin Diabetes Center, Harvard Medical School, Boston, Massachusetts 02215.
5
Barbara Davis Center for Diabetes, University of Colorado Anschutz Medical Campus, Aurora, Colorado 80045.
6
Yale School of Medicine, New Haven, Connecticut 06510.
7
SUNY Upstate Medical University, Syracuse, New York 13210.
8
Xeris Pharmaceuticals, Inc., Austin, Texas 78705.

Abstract

Context:

Standard treatment of hypoglycemia is oral carbohydrate, but it often results in hyperglycemia and entails extra caloric intake.

Objective:

To evaluate low-dose glucagon to treat mild hypoglycemia in ambulatory adults with type 1 diabetes (T1D).

Design:

Randomized crossover trial (two 3-week periods).

Setting:

Five U.S. diabetes clinics.

Patients:

Twenty adults with T1D using an insulin pump and continuous glucose monitor (CGM) and experiencing frequent mild hypoglycemia.

Intervention:

Nonaqueous mini-dose glucagon (MDG) (150 µg) to treat nonsevere hypoglycemia.

Main Outcome Measures:

Successful treatment was defined as blood glucose (BG) ≥50 mg/dL 15 minutes and ≥70 mg/dL 30 minutes after intervention, on the study meter. Two authors, blinded to treatment arm, independently judged each event as a clinical success or failure.

Results:

Sixteen participants (mean age 39 years, 75% female, mean diabetes duration 23 years, mean hemoglobin A1c 7.2%) had 118 analyzable events with initial BG of 50 to 69 mg/dL. Successful treatment criteria were met for 58 (94%) of 62 events during the MDG period and 53 (95%) of 56 events during the glucose tablets (TABS) period (adjusted P = 0.99). Clinical assessments of success for these events were 97% and 96%, respectively. CGM-measured time in range did not differ between treatment groups during the 2 hours after events, but TABS resulted in higher maximum glucose (116 vs 102 mg/dL; P = 0.01) over the first hour.

Conclusions:

Low-dose glucagon can successfully treat mild hypoglycemia and may be a useful alternative to treatment with oral carbohydrate when trying to avoid unnecessary caloric intake.

TRIAL REGISTRATION:

ClinicalTrials.gov NCT02411578.

PMID:
28591776
DOI:
10.1210/jc.2017-00591
[Indexed for MEDLINE]

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