Nasal Spray Is Easy Treatment for Hypoglycemia in Type 1 Diabetes Patients

Nasal glucagon (NG) may be able to treat moderate to severe hypoglycemic episodes (HEs) experienced by adults with type 1 diabetes in everyday settings, according to a recent observational study.

The results of the study were presented at the American Diabetes Association’s 77th Scientific Sessions, held in San Diego, CA, from June 9-13, 2017.
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For their study, the researchers assessed an efficacy population (n = 69) and a safety population (n = 74)  of adult patients with type 1 diabetes who experience moderate to severe HEs. Both patients and caregivers were taught to administer NG, 3 mg, for symptomatic HEs and to monitor for return to normal status. They also self-reported HE symptoms, blood glucose (BG) levels, adverse events (AEs), and ease-of-use in a questionnaire.

Results of the study indicated that 157 HEs were reported in the efficacy group. Of which, 96.2% returned to normal status within 30 minutes of receiving NG. Five patients experiencing HEs returned to normal status between 30 and 45 minutes, and in 4 patients, BG was 70 mg/dL or higher at 30 minutes.

The researchers found the mean BG at onset of HE to be 47.9 mg/dL, which rose to 112.8 mg/dL by 30 minutes and continued to rise over time. No emergency service calls were made. Additionally, in the efficacy population, there were 12 severe HEs in 7 patients. All patients experiencing severe HEs awoke or returned to normal status within 15 minutes.

In the safety population, 179 HEs were experienced, with 87.8% of patients experiencing at least 1 AE. The researchers noted that the most common AEs were nasal irritation (82.4%) and headache (54.1%). Additionally, most AEs lasted an hour or less and were of mild or moderate severity. There were no serious AEs related to the drug.

“NG showed real-world effectiveness when administered to treat moderate or severe HE in [patients] with [type 1 diabetes],” the researchers concluded. “For most HEs (96.2%), [patients] recovered within 30 minutes and there were no emergency calls. The majority of [caregivers] were satisfied with NG. NG is a potential alternative to currently available injectable recombinant glucagon.”

—Christina Vogt

Reference:

Seaquist ER, Dulude H, Zhang MX, et al. Nasal glucagon for the treatment of moderate-to-severe hypoglycemic episodes in real-world settings in adults with type 1 diabetes. Paper presented at: American Diabetes Association’s 77th Scientific Sessions; June 9-13, 2017; San Diego, CA. http://www.abstractsonline.com/pp8/ - !/4297/presentation/10322.