Posted Oct 17 , 2019 04:33 AM
New uses and formulations of glucagon for hypoglycaemia.
Beato-Vibora P. Drugs in Context 2019; 8: 212599
Institute Summary (excerpted from the abstract)
Hypoglycaemia is the more frequent complication of insulin therapy and the main barrier to tight glycaemic control. Injectable glucagon and oral intake of carbohydrates are the recommended treatments for severe and non-severe hypoglycaemia episodes, respectively. Nasal glucagon is currently being developed as a ready-to-use device, to simplify severe hypoglycaemia rescue. Stable forms of liquid glucagon could open the field for different approaches for mild to moderate hypoglycaemia treatment, such as mini-doses of glucagon or continuous subcutaneous glucagon infusion as a part of dual-hormone closed-loop systems. Pharmaceutical companies are developing stable forms of native glucagon or glucagon analogues for that purpose. Glucagon products in the pipeline are listed in the table below.
Why is this important?
Injectable glucagon has been a mainstay in the rescue from severe hypoglycemia. Existing products need to be reconstituted in order to administer them, and are difficult to use for that reason. The glucagon molecule is inherently unstable, and so different companies have tried to stabilize glucagon so that it might be either available in liquid form, or they have tried new routes of administration such as intranasal application of glucagon powder. The latter has just been approved by the FDA and will soon be available in pharmacies. The intranasal powder dosage is 3 mg, and it has been shown to be effective in hypoglycemia rescue. Newer liquid preparations that are more stable will potentially be used in dual hormone insulin pumps, and in some cases will be used in ‘mini’ doses for mild hypoglycemia. Glucagon is underprescribed and underutilized, and these new products are significant advances in the use of this potentially lifesaving hormone. Do you routinely check to make sure your insulin using patients have access to glucagon? Have you shown them how to use it?
Concluding Thought: Every once in a while, a new technology, an old problem, and a big idea turn into an innovation. - Dean Kamen
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