Cargando…

Therapeutic Use of Intranasal Glucagon: Resolution of Hypoglycemia

Episodes of hypoglycemia are frequent in patients with diabetes treated with insulin or sulphonylureas. Hypoglycemia can lead to severe acute complications, and, as such, both prevention and treatment of hypoglycemia are important for the well-being of patients with diabetes. The experience of hypog...

Descripción completa

Detalles Bibliográficos
Autores principales: Pontiroli, Antonio E., Tagliabue, Elena
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6695717/
https://www.ncbi.nlm.nih.gov/pubmed/31349701
http://dx.doi.org/10.3390/ijms20153646
_version_ 1783444100779868160
author Pontiroli, Antonio E.
Tagliabue, Elena
author_facet Pontiroli, Antonio E.
Tagliabue, Elena
author_sort Pontiroli, Antonio E.
collection PubMed
description Episodes of hypoglycemia are frequent in patients with diabetes treated with insulin or sulphonylureas. Hypoglycemia can lead to severe acute complications, and, as such, both prevention and treatment of hypoglycemia are important for the well-being of patients with diabetes. The experience of hypoglycemia also leads to fear of hypoglycemia, that in turn can limit optimal glycemic control in patients, especially with type 1 diabetes. Treatment of hypoglycemia is still based on administration of carbohydrates (oral or parenteral according to the level of consciousness) or of glucagon (intramuscular or subcutaneous injection). In 1983, it was shown for the first time that intranasal (IN) glucagon drops (with sodium glycocholate as a promoter) increase blood glucose levels in healthy volunteers. During the following decade, several authors showed the efficacy of IN glucagon (drops, powders, and sprays) to resolve hypoglycemia in normal volunteers and in patients with diabetes, both adults and children. Only in 2010, based on evaluation of patients’ beliefs and patients’ expectations, a canadian pharmaceutical company (Locemia Solutions, Montreal, Canada) reinitiated efforts to develop glucagon for IN administration. The project has been continued by Eli Lilly, that is seeking to obtain registration in order to make IN glucagon available to insulin users (children and adolescents) worldwide. IN glucagon is as effective as injectable glucagon, and devoid of most of the technical difficulties associated with administration of injectable glucagon. IN glucagon appears to represent a major breakthrough in the treatment of severe hypoglycemia in insulin-treated patients with diabetes, both children and adults.
format Online
Article
Text
id pubmed-6695717
institution National Center for Biotechnology Information
language English
publishDate 2019
publisher MDPI
record_format MEDLINE/PubMed
spelling pubmed-66957172019-09-05 Therapeutic Use of Intranasal Glucagon: Resolution of Hypoglycemia Pontiroli, Antonio E. Tagliabue, Elena Int J Mol Sci Review Episodes of hypoglycemia are frequent in patients with diabetes treated with insulin or sulphonylureas. Hypoglycemia can lead to severe acute complications, and, as such, both prevention and treatment of hypoglycemia are important for the well-being of patients with diabetes. The experience of hypoglycemia also leads to fear of hypoglycemia, that in turn can limit optimal glycemic control in patients, especially with type 1 diabetes. Treatment of hypoglycemia is still based on administration of carbohydrates (oral or parenteral according to the level of consciousness) or of glucagon (intramuscular or subcutaneous injection). In 1983, it was shown for the first time that intranasal (IN) glucagon drops (with sodium glycocholate as a promoter) increase blood glucose levels in healthy volunteers. During the following decade, several authors showed the efficacy of IN glucagon (drops, powders, and sprays) to resolve hypoglycemia in normal volunteers and in patients with diabetes, both adults and children. Only in 2010, based on evaluation of patients’ beliefs and patients’ expectations, a canadian pharmaceutical company (Locemia Solutions, Montreal, Canada) reinitiated efforts to develop glucagon for IN administration. The project has been continued by Eli Lilly, that is seeking to obtain registration in order to make IN glucagon available to insulin users (children and adolescents) worldwide. IN glucagon is as effective as injectable glucagon, and devoid of most of the technical difficulties associated with administration of injectable glucagon. IN glucagon appears to represent a major breakthrough in the treatment of severe hypoglycemia in insulin-treated patients with diabetes, both children and adults. MDPI 2019-07-25 /pmc/articles/PMC6695717/ /pubmed/31349701 http://dx.doi.org/10.3390/ijms20153646 Text en © 2019 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Review
Pontiroli, Antonio E.
Tagliabue, Elena
Therapeutic Use of Intranasal Glucagon: Resolution of Hypoglycemia
title Therapeutic Use of Intranasal Glucagon: Resolution of Hypoglycemia
title_full Therapeutic Use of Intranasal Glucagon: Resolution of Hypoglycemia
title_fullStr Therapeutic Use of Intranasal Glucagon: Resolution of Hypoglycemia
title_full_unstemmed Therapeutic Use of Intranasal Glucagon: Resolution of Hypoglycemia
title_short Therapeutic Use of Intranasal Glucagon: Resolution of Hypoglycemia
title_sort therapeutic use of intranasal glucagon: resolution of hypoglycemia
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6695717/
https://www.ncbi.nlm.nih.gov/pubmed/31349701
http://dx.doi.org/10.3390/ijms20153646
work_keys_str_mv AT pontiroliantonioe therapeuticuseofintranasalglucagonresolutionofhypoglycemia
AT tagliabueelena therapeuticuseofintranasalglucagonresolutionofhypoglycemia