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- Title
Nasal Glucagon Reverses Insulin-induced Hypoglycemia With Less Rebound Hyperglycemia: Pooled Analysis of Clinical Trials.
- Authors
Seaquist, Elizabeth; Giménez, Marga; Yan, Yu; Matsuhisa, Munehide; Kao, Christi Yuting; Wadwa, R Paul; Nagai, Yukiko; Khunti, Kamlesh
- Abstract
Background Rebound hyperglycemia may occur following glucagon treatment for severe hypoglycemia. We assessed rebound hyperglycemia occurrence after nasal glucagon (NG) or injectable glucagon (IG) administration in patients with type 1 diabetes (T1D) and type 2 diabetes (T2D). Methods This was a pooled analysis of 3 multicenter, randomized, open-label studies (NCT03339453, NCT03421379, NCT01994746) in patients ≥18 years with T1D or T2D with induced hypoglycemia. Proportions of patients achieving treatment success [blood glucose (BG) increase to ≥70 mg/dL or increase of ≥20 mg/dL from nadir within 15 and 30 minutes]; BG ≥70 mg/dL within 15 minutes; in-range BG (70-180 mg/dL) 1 to 2 and 1 to 4 hours postdose; and BG >180 mg/dL 1 to 2 and 1 to 4 hours postdose were compared. Incremental area under curve (iAUC) of BG >180 mg/dL and area under curve (AUC) of observed BG values postdose were analyzed. Safety was assessed in all studies. Results Higher proportions of patients had in-range BG with NG vs IG (1-2 hours: P =.0047; 1-4 hours: P =.0034). Lower proportions of patients had at least 1 BG value >180 mg/dL with NG vs IG (1-2 hours: P =.0034; 1-4 hours: P =.0068). iAUC and AUC were lower with NG vs IG (P =.025 and P <.0001). As expected, similar proportions of patients receiving NG or IG achieved treatment success at 15 and 30 minutes (97-100%). Most patients had BG ≥70 mg/dL within 15 minutes (93-96%). The safety profile was consistent with previous studies. Conclusion This study demonstrated lower rebound hyperglycemia risk after NG treatment compared with IG. Clinical Trial Registration NCT03421379, NCT03339453, NCT01994746
- Subjects
HYPOGLYCEMIA; TYPE 1 diabetes; HYPERGLYCEMIA; GLUCAGON; TYPE 2 diabetes; INSULIN pumps; BLOOD sugar monitors
- Publication
Journal of the Endocrine Society, 2024, Vol 8, Issue 4, p1
- ISSN
2472-1972
- Publication type
Article
- DOI
10.1210/jendso/bvae034