Nasal glucagon:  a viable option

By Lisa Foster-McNulty, MSN, RN, CDE

Moderate or severe hypoglycemia can be managed in an effective and efficient manner with nasal glucagon, according to the results of a study done on adults with Type 1 diabetes in a real-world setting. 

Elizabeth Seaquist, MD, is the director of the division of diabetes, endocrinology, and metabolism at the University of Minnesota .  She is also a consultant for Eli Lilly and Co.  Along with her colleagues, she provided Type 1 study participants with a nasal device to be used when they had hypoglycemic episodes (HEs).  There were 69 study participants, and a total of 157 HEs which were treated with nasal glucagon.  Blood glucose (BG) levels were between 21.6 and 73.9 mg/dl (1.2-4.1 mmol/L). 

The nasal powder caused some localized irritation as well as headache, and these side effects tended to last no more than an hour.  Side effects such as nausea and vomiting were comparable to side effects noted with the use of injected glucagon.  The research revealed that BG levels returned to normal within half an hour in 96.2% of the HEs.

Dr. Seaquist and her team said that most of the patients and their caregivers found the nasal glucagon to be satisfactory, deeming it to be a viable alternative to recombinant glucagon for injection. 

Locemia is the company that originally developed the nasal glucagon.  Along with Eli Lilly, Locemia funded this study.  Additionally, the study researchers disclosed relevant relationships. 

The need to reconstitute injected glucagon can be too overwhelming for a caregiver during an unconscious low, and therefore the caregiver may not be willing to administer it.  The availability of a nasal glucagon might mean that a patient gets prompt treatment for an unconscious low, and that would be a very good thing, indeed!