Nasal Glucagon May Soon Be Publicly Available for the Treatment of Hypoglycemia

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Glucagon is a hormone normally produced by the pancreas, and it has the opposite effect on the body that insulin does—it raises the blood glucose. For people with diabetes who are prone to hypoglycemic attacks (defined as blood sugar below 70 mg/dL or 3.9 mmol/L), the manmade version of this hormone is available in injection form to save lives in cases of extremely low blood sugar.

This emergency medication is currently delivered intravenously, subcutaneously or intramuscularly, via an injection. But soon, a much easier delivery method may be available.

In two trials, data has shown that a nasal form of glucagon treatment, created by pharmaceutical company Locemia, appears to be effective in real-world situations. Eli Lilly has now officially applied to the FDA for approval of their nasal glucagon treatment for diabetic hypoglycemic attacks. If it is approved, it will be the first dry powder nasal spray on the market for the purpose of treating hypoglycemia.

In the first trial, people with diabetes and their loved ones were instructed to administer the nasal glucagon treatment in the case of a moderate to severe low. 69 of the 74 people involved in the study had a total of 157 hypoglycemic attacks, 12 of which were considered severe. In 96 percent of cases, patients regained consciousness or returned to a “normal” state within 30 minutes. The 12 patients who experienced severe episodes, along with many of the others, returned to normal within 15 minutes.

In the second trial, caregivers of a small group of diabetic children and teens were instructed to administer nasal glucagon during moderate to severe lows. 14 patients experienced a total of 33 moderate hypoglycemic events, and all of them returned to “normal,” as judged by the caregiver, within 30 minutes. Over half of the episodes were resolved within 10 minutes.

Eli Lilly expects that the nasal glucagon treatment will be easier to administer, as people are often fearful when it comes to injections and needles. The drug also requires less training and fewer instructions than injectable glucagon, saving precious moments in a life-threatening situation.

“Lilly is committed to bringing nasal glucagon to market as soon as possible, as we believe a simple, ready-to-use approach to treating severe hypoglycemia via nasal delivery could be an important advance for people with diabetes and their caregivers,” says the pharmaceutical company. “It may also expand the community of people who could quickly render aid in a rescue situation.”

The most common side effects of the drug include nasal irritation and headache, which are small prices to pay for a potentially lifesaving treatment.

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Elizabeth Nelson is a wordsmith, an alumna of Aquinas College in Grand Rapids, a four-leaf-clover finder, and a grammar connoisseur. She has lived in west Michigan since age four but loves to travel to new (and old) places. In her free time, she. . . wait, what’s free time?
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