Glucagon use by U.S. adults with type 1 and type 2 diabetes
Open accessAbstract
The American Diabetes Association recommends that all patients at risk for hypoglycemia be prescribed glucagon. Despite this recommendation, there is evidence that prescription rates are lower than expected for patients with type 1 and type 2 diabetes. This study investigated prescription patterns for glucagon among de-identified administrative claims from OptumLabs® Data Warehouse for prescriptions between January 1, 2014 and December 31, 2014 among pharmacologically treated type 1 and 2 diabetes patients. We find that glucagon was rarely filled by patients with type 1 and type 2 diabetes, including fewer than 5% of patients with prior hypoglycemia requiring emergency healthcare utilization. Among patients with type 1 diabetes, glucagon fills were unpredictable and not targeted to highest risk patients.
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Appropriate glucagon prescribing is very low in current practice.
“For these individuals, clinicians should routinely review their access to glucagon, as appropriate glucagon prescribing is very low in current practice (140-142).”
From 6. Glycemic Goals, Hypoglycemia, and Hyperglycemic Crises: Standards of Care in Diabetes-2026. (2026) · cites this paper as [140]
The Results and Discussion report that glucagon was rarely filled in the studied population, including by fewer than 5% of patients with prior hypoglycemia requiring emergency care. But the study measured prescriptions filled, not all prescriptions written, and the Discussion cautions that its 2014 data may not reflect current practice. (LLM, conf=0.88)
Experimental — accuracy not yet measuredAppropriate glucagon prescribing is low.
“Clinicians should routinely review the individual's access to glucagon, as appropriate glucagon prescribing is low (191)(192)(193).”
From 9. Pharmacologic Approaches to Glycemic Treatment: Standards of Care in Diabetes—2025 (2025) · cites this paper as [192]
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References 8 · Cited by 27
Research works printed but not linked: 1
- [5]OptumLabs and OptumLabs Data Warehouse (OLDW) Descriptions and Citation.. In: OptumLabs, ed. Cambridge, MA 2019.
- Authors
- Kahn, P. A., Liu, S., McCoy, R., Gabbay, R. A., & Lipska, K.
- Affiliations
- Yale University (US)
- Mayo Clinic (US)
- Joslin Diabetes Center (US)
- Yale New Haven Hospital (US)
- Corresponding author
- Lipska, Kasia
- Venue
- Journal of Diabetes and its Complications
- Publisher
- Elsevier BV
- Published
- 2021-05
- Volume
- 35
- Issue
- 5
- Pages
- 107882
- ISSN
- 0891-6632 (ISSN-L)
- 1056-8727
- PMC
- PMC8054027
- OpenAlex
- W3128015534
- Cited by
- 27
- References
- 8
- Citations by year
- 2025: 7 · 2024: 4 · 2023: 12 · 2022: 4
- FWCI
- 3.73
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Journal of Diabetes and its Complications (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- Centers for Medicare and Medicaid Services
- National Institutes of Health
- National Institute of Diabetes and Digestive and Kidney Diseases (K23DK114497)
- National Institute on Aging
- American Federation for Aging Research (K23AG048359)
- 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 › Endocrinology, Diabetes and Metabolism › Diabetes Management and Education
- Keywords
- glucagon, type 1 diabetes, type 2 diabetes, hypoglycemia, prescribing patterns, medication utilization, risk stratification
- MeSH terms
- Adult, Diabetes Mellitus, Type 1, Diabetes Mellitus, Type 2, Glucagon, Humans, Hypoglycemia, Hypoglycemic Agents, Retrospective Studies, United States
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