Using neuroimaging to understand mechanisms of hypoglycaemia unawareness
Understanding the impact of hypoglycaemia: severe, non-severe and sensor detected hypoglycemia
The role of subcutaneous glucagon
Abstract
Background and Aims / Part 1
Type 1 diabetes mellitus is characterized not only by insulin deficiency, but also dysregulation of endogenous glucagon secretion. Impaired glucagon response to hypoglycemia renders the person with diabetes prone to severe hypoglycemia and represents one of the major impediments to achieving optimal glycemic control and quality of life. Due to instability of recombinant glucagon in liquid form, until now the only roles of subcutaneous glucagon in the treatment of type 1 diabetes have been as rescue for severe hypoglycemia, and less commonly, mini-doses for prevention of hypoglycemia during acute illness or exercise. The recent availability of liquid-stable glucagon has enabled the development of improved methods to treat and/or prevent hypoglycemia, as well as raised the possibility of feasible dual-hormone artificial pancreas systems. This presentation will highlight key studies demonstrating the importance of glucagon in successful management of type 1 diabetes, both as a standalone drug and as part of a dual-hormone system.
Nasal glucagon: a novel rescue option for severe hypoglycemia
Abstract
Background and Aims / Part 1
For many years, treatment of severe hypoglycemia has remained relatively stagnant requiring use of a multistep, injection kit in order to administer glucagon. This complex task to be orchestrated during a stressful time was prone to error, or even the decision to forgo treatment. Thus, alternate glucagon formulations have been explored, with nasal glucagon administration first being assessed in the 1980s. Over the past decade, studies of nasal glucagon have gone from rigorous inpatient trials to outpatient assessments with real-world application of the product. This presentation will review these trials, as well as simulation studies and provide updates regarding use of nasal glucagon as it has become commercially available.