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Curr Diab Rep. 2019 Sep 6;19(10):97. doi: 10.1007/s11892-019-1216-4.

Novel Preparations of Glucagon for the Prevention and Treatment of Hypoglycemia.

Author information

1
Division of Endocrinology and Diabetes, Department of Pediatrics, The Children's Hospital of Philadelphia, Philadelphia, PA, USA.
2
Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
3
Institute for Diabetes, Obesity & Metabolism, Perelman School of Medicine, University of Pennsylvania, 12-134 Smilow Center for Translational Research, 3400 Civic Center Blvd, Philadelphia, PA, 19104, USA.
4
Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA. rickels@pennmedicine.upenn.eduas.
5
Institute for Diabetes, Obesity & Metabolism, Perelman School of Medicine, University of Pennsylvania, 12-134 Smilow Center for Translational Research, 3400 Civic Center Blvd, Philadelphia, PA, 19104, USA. rickels@pennmedicine.upenn.eduas.
6
Division of Endocrinology, Diabetes & Metabolism, Department of Medicine, Hospital of the University of Pennsylvania, Philadelphia, PA, USA. rickels@pennmedicine.upenn.eduas.

Abstract

PURPOSE OF REVIEW:

New more stable formulations of glucagon have recently become available, and these provide an opportunity to expand the clinical roles of this hormone in the prevention and management of insulin-induced hypoglycemia. This is applicable in type 1 diabetes, hyperinsulinism, and alimentary hypoglycemia. The aim of this review is to describe these new formulations of glucagon and to provide an overview of current and future therapeutic opportunities that these may provide.

RECENT FINDINGS:

Four main categories of glucagon formulation have been studied: intranasal glucagon, biochaperone glucagon, dasiglucagon, and non-aqueous soluble glucagon. All four have demonstrated similar glycemic responses to standard glucagon formulations when administered during hypoglycemia. In addition, potential roles of these formulations in the management of congenital hyperinsulinism, alimentary hypoglycemia, and exercise-induced hypoglycemia in type 1 diabetes have been described. As our experience with newer glucagon preparations increases, the role of glucagon is likely to expand beyond the emergency use that this medication has been limited to in the past. The innovations described in this review likely represent early examples of a pending large repertoire of indications for stable glucagon.

KEYWORDS:

Alimentary; Diabetes; Formulation; Glucagon; Hyperinsulinism; Hypoglycemia

PMID:
31493043
DOI:
10.1007/s11892-019-1216-4

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