Glucagon for hypoglycemic episodes in insulin-treated diabetic patients: a systematic review and meta-analysis with a comparison of glucagon with dextrose and of different glucagon formulations

Boido, Augusto; Ceriani, Valerio; Pontiroli, Antonio E.

doi:10.1007/s00592-014-0665-0

Cited by 29 publications

(38 citation statements)

References 55 publications

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“…This study indicates, once again, that peptides administered IN may exert effects different from those with usual parenteral administration, as with insulin . Aside from interest in the physiology of alternative routes of peptide administration, a meta‐analysis showed that IN and IM glucagon are similarly effective …”

Section: Glucagonmentioning

confidence: 73%

“…With the acquisition of the product by Eli‐Lilly in 2015, he no longer had contacts of any kind with pharmaceutical companies involved in intranasal glucagon. He received an unrestricted grant from Locemia Solutions ULC for preparation of the meta‐analysis referenced in the text . V. C. declares no conflict of interest.…”

Section: Resultsmentioning

confidence: 99%

“…In contrast, dextrose‐treated patients seemed to have more fluctuations in blood glucose. A meta‐analysis comparing IV dextrose and IM glucagon showed that the effectiveness is similar, and that the ineffectiveness of glucagon and dextrose is infrequent …”

Section: Glucagonmentioning

confidence: 99%

“…In spite of these data, a marketable IN glucagon product has not been commercialized by any pharmaceutical company. Starting in 2010, there has been renewed interest, and IN glucagon is now being developed to meet the unmet medical need for an easily‐administered glucagon to treat SH . Eli Lilly is now completing development of a product originally developed by Locemia.…”

Section: Glucagonmentioning

confidence: 99%

“…A meta-analysis comparing IV dextrose and IM glucagon showed that the effectiveness is similar, and that the ineffectiveness of glucagon and dextrose is infrequent. 27 Recently, to determine the direct economic impact of management of severe hypoglycaemia among individuals with diabetes in Italy, 28,29…”

Section: Glucagonmentioning

confidence: 99%

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Intranasal glucagon for hypoglycaemia in diabetic patients. An old dream is becoming reality?

Pontiroli

Ceriani

2018

Diabetes Obesity Metabolism

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In 1983 it was shown that glucagon administered intranasally (IN) was absorbed through the nasal mucosa and increased blood glucose in healthy subjects. Shortly thereafter, it was shown that IN glucagon counteracts with hypoglycaemia in insulin-treated diabetic patients. In spite of this evidence, IN glucagon was not developed by any pharmaceutical company before 2010, when renewed interest led to intensive evaluation of a possible remedy for hypoglycaemia in insulin-treated diabetic adults and children. IN glucagon is now being developed as a needle-free device that delivers glucagon powder for treatment of severe hypoglycaemia; the ease of using this device stands in stark contrast to the difficulties encountered in use of the current intramuscular glucagon emergency kits. Studies have demonstrated the efficacy, safety and ease-of-use of this IN glucagon preparation, and suggest IN glucagon as a promising alternative to injectable glucagon for treating severe hypoglycaemia in children and adults who use insulin. This would meet the unmet medical need for an easily administered glucagon preparation.

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Section: Glucagonmentioning

confidence: 73%

Section: Resultsmentioning

confidence: 99%

Section: Glucagonmentioning

confidence: 99%

Section: Glucagonmentioning

confidence: 99%

Section: Glucagonmentioning

confidence: 99%

See 3 more Smart Citations

Intranasal glucagon for hypoglycaemia in diabetic patients. An old dream is becoming reality?

Pontiroli

Ceriani

2018

Diabetes Obesity Metabolism

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Clinical Pharmacology of Glucagon

Kronfol,

Chow,

Lau

et al. 2024

Clin Pharma and Therapeutics

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Glucagon was discovered about a hundred years ago and its role in health and disease is under continuous investigation. Glucagon is a counter regulatory hormone secreted by alpha cells of the pancreas in response to multiple stimuli. Although some of glucagon's actions and its clinical application have been described, clinical experience with glucagon has been historically overshadowed by that of insulin. To date, the role of glucagon's actions in pharmacotherapy has been under explored. Glucagon plays a considerable role as a hormonal regulator via its known actions on the liver. The rise in obesity and diabetes mellitus prevalence is bringing focus to glucagon's known physiological roles and possible clinical applications. Six glucagon products and a glucagon analog are approved for use in the United States. Clinical pharmacology studies provide crucial support of glucagon's actions as evident from comprehensive pharmacokinetics and pharmacodynamics evaluations in humans. Here, we briefly describe the established physiological role of glucagon in humans and its known relationship with disease. We later summarize the clinical pharmacology of available glucagon products with different routes of administration.

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Glucagon for hypoglycaemia treatment in type 1 diabetes

Ranjan

Schmidt

Nørgaard

2020

Diabetes Metabolism Res

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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.

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Glucagon for hypoglycemic episodes in insulin-treated diabetic patients: a systematic review and meta-analysis with a comparison of glucagon with dextrose and of different glucagon formulations

Abstract: These data indicate that ineffectiveness of glucagon is unfrequent, not different from dextrose; in addition, intranasal and injected glucagon are similarly effective. In the case of failure, a second dose can be administered.

Cited by 29 publications

References 55 publications

Intranasal glucagon for hypoglycaemia in diabetic patients. An old dream is becoming reality?

Intranasal glucagon for hypoglycaemia in diabetic patients. An old dream is becoming reality?

Clinical Pharmacology of Glucagon

Glucagon for hypoglycaemia treatment in type 1 diabetes

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