Nasal glucagon (NG), a ready-to-use drug-device combination for the treatment of severe hypoglycemia (SH), contains 3 mg glucagon dry powder that is absorbed through the nasal mucosa. A clinical trial (CT) and a real-world study (RWS) examined efficacy, effectiveness, and tolerability of NG in reversing hypoglycemia in children with type 1 diabetes (T1D).
Post hoc analyses were performed using data from participants, 4 to 17 years old, whose insulin-induced nadir blood glucose (BG) reached ≤70 mg/dL (CT) or whose baseline BG reached <54 mg/dL (RWS). Treatment success was defined as ≥25 mg/dL BG increase from nadir within 30 min of glucagon treatment (CT) or return to normal status from neuroglycopenic symptoms within 30 min of NG treatment (RWS).
In the CT, NG (n=16) and injectable glucagon (IG) (n=12) achieved treatment success in 100% of participants, in mean times (excluding glucagon preparation) of 14 min and 13 min, respectively. Nadir BG was 63 mg/dL for NG and 62 mg/dL for IG. Incidences of NG and IG adverse events (AE) were similar for nausea and vomiting; headache and nasal symptoms occurred more frequently with NG than IG. In the RWS, NG resolved all 17 events (mean baseline BG=49 mg/dL) within 30 min (mean time=14 min). NG administration was considered easy or very easy during 16 of 17 events. The most common reported adverse symptoms were nasal discomfort, headache and watering eyes.
NG is an effective, well-tolerated and easy-to-use treatment for SH in children with T1D.