The Glucagon Content of Crystalline Insulin Preparations

Staub, Alfred; Behrens, Otto K.

doi:10.1172/jci103043

Cited by 35 publications

(11 citation statements)

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“…Significant amyloid formation has been reported to occur within 24 hours and is potentially toxic to cells. [78][79][80] Finally, a 1 mg glucagon emergency kit costs ~$80-100 at current prices; therefore frequent use of mini-dose glucagon to correct mildly low glucose values could add significant financial burden to the disease. Nevertheless, the increased cost of glucagon therapy should be considered alongside the potential savings from a decline in severe hypoglycemic episodes requiring emergency treatment.…”

Section: Considerations Of Mini-dose Glucagon Therapy and Future Treamentioning

confidence: 99%

Minimizing Morbidity of Hypoglycemia in Diabetes

Chung

Haymond

2014

J Diabetes Sci Technol

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Type 1 diabetes is a common chronic disease of childhood and one of the most difficult conditions to manage. Advances in insulin formulations and insulin delivery devices have markedly improved the ability to achieve normal glucose homeostasis. However, hypoglycemia remains the primary limiting factor in achieving normoglycemia and is a frequent complication in children with acute gastroenteritis and/or poor oral intake. In situations of impaired carbohydrate intake or absorption, glucagon therapy is the only out-of-hospital treatment option available to families and caregivers. Glucagon is recommended for the treatment of severe hypoglycemia and rapidly increases blood glucose by increasing hepatic glucose production from glycogenolysis. Mini-dose glucagon is a widely utilized off-label treatment for managing mild or impending hypoglycemia and is administered as a small subcutaneous injection. It was initially described for use in children who were unable to tolerate or absorb oral carbohydrates but not in need of advanced medical care. Yet, mini-dose glucagon may be useful in any individual with relative insulin excess. The regimen aims to prevent severe hypoglycemic episodes and is safe, effective, and easily administered by patients and caregivers in the out-of-hospital setting. By empowering patients and their families, this important tool could help to alleviate the physical, psychosocial, and financial burden evolving from impending hypoglycemia.

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Section: Considerations Of Mini-dose Glucagon Therapy and Future Treamentioning

confidence: 99%

Minimizing Morbidity of Hypoglycemia in Diabetes

Chung

Haymond

2014

J Diabetes Sci Technol

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“…Some of our data would make one question this simple explanation of the relative actions of glucagon and insulin. There is agreement that a relatively small dose of glucagon will cause a maximal rise in blood sugar and further increases in dosage will have no additional effect (3,4,10). In preliminary studies on patients not receiving insulin we have found that this dose is definitely less than 0.01 mg. per kg.…”

Section: Discussionmentioning

confidence: 92%

“…The subcutaneous route was much poorer than either of the other routes. 4. Responsiveness to glucagon increased during the course of insulin coma therapy.…”

Section: Discussionmentioning

confidence: 99%

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The Effect of Glucagon on the Blood Glucose Level and the Clinical State in the Presence of Marked Insulin Hypoglycemia 12

Schulman¹,

Greben²

1957

J. Clin. Invest.

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The increasing evidence that glucagon is a naturally occurring hormone has led to considerable interest and speculation as to its possible metabolic roles. The possibility of obtaining glucagon in increasingly pure preparations and the final obtainment of a crystalline preparation (1) have added impetus to this interest.The presence of a hyperglycemic contaminant was one of the suggestions advanced to explain the initial rise in the blood sugar level which followed the administration of some preparations of insulin. There is general agreement that glucagon can cause at least a temporary rise in the blood sugar level in the presence of insulin. However, considerable interest still centers around the question of the relative effects of insulin and glucagon on the blood sugar level (2-5).It was believed that there would be some advantage in exploring the effect of glucagon in patients who had received massive doses of insulin. This situation obtains in the insulin coma treatment of psychiatric patients. It was also considered that glucagon could serve as a useful means of terminating insulin coma. The present report deals with these questions. MATERIALS AND METHODSThe patients used for this study were all hospitalized at The Henry Phipps Psychiatric Clinic and were diagnosed as exhibiting schizophrenic reactions. There were 11 patients, of whom 6 were women and 5 were men. They ranged in age from 16 to 48 years with an average age of 28 years. They were all in good physical health.All of these patients were receiving insulin coma therapy as part of the therapeutic regimen for their I This investigation, under the direction of Dr. John C.Whitehorn, was supported by a research grant (M-1085) from the National Institute of Mental Health of the Na- Insulin comas were terminated with glucagon in 141 instances. Of this total glucagon was administered intravenously 97 times, intramuscularly 22 times and subcutaneously on 22 occasions. Following 61 of these terminations of coma the response to glucagon was followed with blood sugar determinations. Blood was withdrawn from an antecubital vein several minutes before the administration of the glucagon and at 5, 10, 15, 20, 30, 40, and 50 minutes following the administration of the glucagon. A separate venipuncture was performed for each determination. There was some variation in the timing of the withdrawals for technical reasons. On two occasions more than one dose of glucagon was administered. The coma was considered clinically terminated when the patient was able to respond verbally to questions or was able to take fluids by mouth with minimal difficulty.In addition, seven of the patients had a series of three tests in which glucagon was administered on days when they had not received insulin. In each instance the first of the three tests was performed the day before insulin coma therapy was instituted, the second on the day after they had reached the highest insulin dose in the series of comas and the third on the day following the last insulin coma treatment. A fastin...

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“…São êles: 1) medida do efeito hiperglicêmico do glucagon injetado em gatos (Staub e Behrens, 1954); 2) medida de quantidade de glicose liberada de fatias de figado «in vitro» (Sutherland e Rali, 1958;Vuylsteke et al, 1950;Audy e Kerly, 1952;Tybergheim e Williams, 1958); 3) medida da reativação da fosforilase em fatias ou homogeneizados de figado (B erthet e t al., 1957); 4) imuno-ensaio baseado na capacidade de liga ção ao anti-corpo (Unger et al, 1961). Em bora os três p ri meiros métodos não ofereçam a precisão e especificidade dese jadas, têm contribuido p ara aum entar o conhecimento sôbre o glucagon.…”

Section: Introductionunclassified

Efeitos do Glucagon no metabolismo glicídico de Chrysemys d'orbignyi (Reptilia, Chelonia) sob a influência das variações estacionais

Marques¹

1970

Bol. Inst. Biociênc. Univ. São Paulo, Nova Sér. Zool. Biol. Mar

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The Glucagon Content of Crystalline Insulin Preparations

Cited by 35 publications

References 10 publications

Minimizing Morbidity of Hypoglycemia in Diabetes

Minimizing Morbidity of Hypoglycemia in Diabetes

The Effect of Glucagon on the Blood Glucose Level and the Clinical State in the Presence of Marked Insulin Hypoglycemia 12

Efeitos do Glucagon no metabolismo glicídico de Chrysemys d'orbignyi (Reptilia, Chelonia) sob a influência das variações estacionais

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