Kamlesh Khunti, United Kingdom
University of Leicester Diabetes Research CentrePresenter of 1 Presentation
NASAL GLUCAGON REVERSED INSULIN-INDUCED HYPOGLYCAEMIA IN ADULTS WITH DIABETES: A POOLED ANALYSIS
Abstract
Background and Aims
Nasal glucagon (NG), a ready-to-use drug-device combination for treatment of severe hypoglycaemia, contains 3 mg glucagon dry powder that is absorbed passively through nasal mucosa. We examined the efficacy and safety of NG compared to 1 mg injectable glucagon (IG) in reversing insulin-induced hypoglycaemia in a global population of adults with type 1 diabetes (T1D) and type 2 diabetes (T2D.). Notably, this is the first analysis including pooled T2D data.
Methods
Post-hoc analyses used data from 3 randomised, cross-over studies. Treatment success was defined as an increase in blood glucose to ≥3.9 mmol/L (70 mg/dL) or an increase of ≥1.1 mmol/L (20 mg/dL) from nadir blood glucose within 30 min of receiving glucagon. Tolerability was assessed using treatment-emergent adverse events and a symptom questionnaire.
Results
In the T1D+T2D pooled analysis, 99.5% (213/214) of NG and 100% (214/214) of IG administrations achieved treatment success in a mean (median) time of 13 (10) minutes and 11 (10) minutes, respectively. The times (mean [median]) for achieving treatment success for participants with T2D (N=41) were similar for NG (12 [10] minutes) and IG (11 [10] minutes). NG and IG induced similar blood glucose changes (figure). NG and IG had similar incidences of nausea and vomiting, with NG having a higher rate of side effects related to nasal administration [headache (13% NG, 7% IG), nasal discomfort (4% NG, 1% IG), etc.]. Separate T1D and T2D analyses showed similar results as T1D+T2D.
Conclusions
NG was efficacious and well-tolerated in reversing insulin-induced hypoglycaemia in adults with T1D and T2D.