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Hypoglycemia in Adults With Type 1 Diabetes

Mini-Dose Ready-to-Use Glucagon can Prevent Exercise-Induced Hypoglycemias

article by kathryn

A topic I always cover with patients is how to mini-dose glucagon and why it’s an important thing to know how to do (especially for sick days and the potential of a stomach bug, not being able to keep anything down and blood sugar reading low).

Personally, since the Gvoke kit hit the market, I’ve enjoyed using it to avoid hypos around exercise. It’s a nice way to avoid extra caloric intake. Personally, with some trial and error, I found that I could get through an entire CrossFit workout if I injected 3U (via an insulin syringe) of glucagon  5 mins prior to the onset. Unfortunately, we have very little research to reference for how much glucagon to dose.

Recently, a study was conducted using ready-to-use glucagon to prevent exercise-induced hypoglycemia.

The participants of the study completed an in-clinic training phase for which they were randomly assigned 150 µg glucagon or placebo subcutaneously, immediately before exercise. In addition, they ran a 50% basal decrease. The next phase of the study had participants doing their usual aerobic exercise at moderate to high intensity for 30-75 min in real-world, outpatient settings. For all exercise sessions in the outpatient phase, incidence of hypoglycemia was lower than in the placebo arm. Additionally, the amount of carbohydrate needed was lower with glucagon use than with placebo use, but did not reach statistical significance.

Overall, this is exciting research.

Currently, mini-dosing glucagon is considered off-label use. People with diabetes can greatly benefit from utilizing it for reasons other than just the treatment of severe hypoglycemia and with ready-to-use glucagon, it’s now easier than ever. Xeris, the manufacturer of Gvoke, is currently doing research on mini-dosing. Healthcare providers can ask their Xeris rep for the data that has been collected.

Read the original article here:
Ronnie Aronson, Michael C. Riddell, Valentina Conoscenti, M. Khaled Junaidi; Effect of Mini-Dose Ready-to-Use Liquid Glucagon on Preventing Exercise-Associated Hypoglycemia in Adults With Type 1 Diabetes. Diabetes Care 2023; dc221145.

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