Novel preparations of glucagon for the prevention and treatment of hypoglycemia
Open accessAbstract
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.
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Alpha-glucosidase inhibitors block the digestion and uptake of complex carbohydrates and disaccharides.
“In persons with T2D being treated with alpha-glucosidase inhibitors, who develop hypoglycemia due to use of hypoglycemic agents, oral glucose or lactose-containing foods (dairy products) must be given because alpha-glucosidase inhibitors inhibit the breakdown and absorption of complex carbohydrates and disaccharides.1218–1225”
From American Association of Clinical Endocrinology Clinical Practice Guideline: Developing a Diabetes Mellitus Comprehensive Care Plan-2022 Update. (2022) · cites this paper as [1224]
The Alimentary Hypoglycemia section discusses carbohydrate intake after gastric bypass, not alpha-glucosidase inhibitors. Searches for the inhibitors, their effects on carbohydrate digestion and absorption, and the proposed oral-glucose or lactose treatment found no passage addressing the attributed claim. No page number was available in our copy. (LLM, conf=0.74)
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References 69 · Cited by 46
- Authors
- Hawkes, C. P., De Leon, D. D., & Rickels, M. R.
- Affiliations
- Children's Hospital of Philadelphia (US)
- Hospital of the University of Pennsylvania (US)
- Corresponding author
- Rickels, Michael R.
- Venue
- Current Diabetes Reports
- Published
- 2019-09-06
- Volume
- 19
- Issue
- 10
- Pages
- 97-97
- ISSN
- 1534-4827 (ISSN-L)
- 1539-0829
- PMC
- PMC6951434
- OpenAlex
- W2971809673
- Cited by
- 46
- References
- 69
- Citations by year
- 2025: 4 · 2024: 8 · 2023: 11 · 2022: 12 · 2021: 7 · 2020: 3 · 2018: 1
- FWCI
- 0.85
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Current Diabetes Reports (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Cork Open Research Archive (University College Cork, Ireland) (submittedVersion)
- Funders
- Dexcom
- National Institutes of Health (5r01dk091331-10, DK098517, DK056268)
- National Institute of Diabetes and Digestive and Kidney Diseases (R01-DK-091331, R01DK098517, R01DK056268)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
- Health Sciences › Medicine › Surgery › Pancreatic function and diabetes
- Keywords
- glucagon, insulin-induced hypoglycemia, type 1 diabetes, congenital hyperinsulinism, exercise-induced hypoglycemia, dasiglucagon, hypoglycemia prevention
- MeSH terms
- Blood Glucose, Diabetes Mellitus, Type 1, Glucagon, Homeostasis, Hormones, Humans, Hypoglycemia, Exercise
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