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. 2011:4:337-46.
doi: 10.2147/DMSO.S20633. Epub 2011 Sep 6.

Treatment of severe diabetic hypoglycemia with glucagon: an underutilized therapeutic approach

Nitil Kedia  1
Affiliations

Treatment of severe diabetic hypoglycemia with glucagon: an underutilized therapeutic approach

Nitil Kedia. Diabetes Metab Syndr Obes. 2011.

Abstract

Tight glycemic control is important in reducing and delaying vascular complications in type 1 and 2 diabetes patients; however, the benefits achieved through strict metabolic control are counterbalanced by an increased risk of hypoglycemia. Glucagon is an effective therapy for treating severe hypoglycemia. Available as an emergency kit, glucagon is an essential tool for rapid response, but remains underappreciated and underused. This article reviews the role of glucagon in treating severe hypoglycemia and discusses the need for better education on glucagon for people with diabetes and their caregivers in order to alleviate fears of hypoglycemia and of administering glucagon in the event of an emergency.

Keywords: glucagon; severe hypoglycemia; type 1 diabetes; type 2 diabetes.

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Figures

Figure 1
Figure 1
Distribution of self-reported number of episodes of severe hypoglycemia during the preceding year in 1049 unselected subjects with type 1 diabetes (light bars) and 209 patients with type 1 diabetes selected by criteria to mimic the characteristics of the DCCT cohort (dark bars). Reprinted from Diabetes Metab Res Rev, 20, U Pedersen-Bjergaard, S Pramming, SR Heller, et al, Severe hypoglycaemia in 1076 adult patients with type 1 diabetes: influence of risk markers and selection, 479–486, copyright (2004), with permission from John Wiley & Sons.
Figure 2
Figure 2
Causes identified by patients for severe hypoglycemic events (as % of group). White bar = total of all countries (type 1, 319; type 2, 320); black bar = UK (type 1, 101; type 2, 100), grey bar = Germany (type 1, 94; type 2, 120), dotted bar = Spain (type 1, 124; type 2, 100). Reprinted from J Med Econ, 12, M Lammert, M Hammer, BM Frier, Management of severe hypoglycaemia: cultural similarities, differences and resource consumption in three European countries, 269–280, copyright (2009), with permission from Informa Healthcare Communications.
Figure 3
Figure 3
Glycemic threshold levels for onset of acute hypoglycemia symptoms in nondiabetic subjects. Reprinted from Hypoglycaemia and diabetes, Handbook of Diabetes, Oxford: Blackwell Publishing Ltd, 1st revision, G Williams, JC Pickup (editors), copyright (1998), with permission from John Wiley & Sons.
Figure 4
Figure 4
Changes in blood glucose levels before and after the administration of 1 mg biosynthetic glucagon. Reprinted from Diabetes Res Clin Pract, 19, M Namba, T Hanafusa, N Kono, et al, Clinical evaluation of biosynthetic glucagon treatment for recovery from hypoglycemia developed in diabetic patients, 133–138, copyright (1993), with permission from Elsevier. Abbreviations: iv, intravenous; im, intramuscular.
See this image and copyright information in PMC

References

    1. Diabetes Control and Complications Trial (DCCT) Resarch Group. The absence of a glycemic threshold for the development of long-term complications: the perspective of the Diabetes Control and Complications Trial. Diabetes. 1996;45(10):1289–1298. - PubMed
    1. The Diabetes Control and Complications Trial (DCCT) Research Group. Hypoglycemia in the Diabetes Control and Complications Trial. Diabetes. 1997;46(2):271–286. - PubMed
    1. UK Prospective Diabetes Study (UKPDS) Group. Intensive blood-glucose control with sulphonylureas or insulin compared with conventional treatment and risk of complications in patients with type 2 diabetes (UKPDS 33) Lancet. 1998;352(9131):837–853. - PubMed
    1. Skyler JS, Bergenstal R, Bonow RO, et al. Intensive glycemic control and the prevention of cardiovascular events: implications of the ACCORD, ADVANCE, and VA diabetes trials: a position statement of the American Diabetes Association and a scientific statement of the American College of Cardiology Foundation and the American Heart Association. Diabetes Care. 2009;32(1):187–192. - PMC - PubMed
    1. Stratton IM, Adler AI, Neil HA, et al. Association of glycemia with macrovascular and microvascular complications of type 2 diabetes (UKPDS 35): prospective observational study. Br Med J. 2000;321(7258):405–412. - PMC - PubMed