Nasal glucagon, first treatment for severe hypoglycemia that can be administered without an injection

Dr KK Aggarwal

The US Food and Drug Administration has approved the first glucagon therapy that can be administered without an injection for the emergency treatment of severe hypoglycemia in patients with diabetes; it is approved for patients with diabetes aged 4 years and older.

Administered as a nasal powder, it does away with the need of the multiple steps of mixing powder and liquid involved with the injection, thus simplifying the treatment. This is particularly useful in critical situations when the patient may have lost consciousness or may be having a seizure. 

Formulation: The nasal powder will be available as a single-use dispenser.

Mechanism of action: It increases blood sugar levels by stimulating the liver to release stored glucose into the bloodstream.

Contraindications

• Patients with a known hypersensitivity to glucagon or the inactive ingredients found in the powder.
• Patients with pheochromocytoma or insulinoma.

Adverse effects: Nausea, vomiting, headache, upper respiratory tract irritation, watery eyes, redness of eyes and itchiness. Side effects are similar to injectable glucagon, with the addition of nasal and eye-related symptoms, such as watery eyes and nasal congestion, because of the route of administration.

Warning: It should be used with caution by those who have been fasting for long periods, have adrenal insufficiency or have chronic hypoglycemia because these conditions result in low levels of releasable glucose in the liver.

(Source: FDA)

Dr KK Aggarwal

Padma Shri Awardee

President Elect Confederation of Medical Associations in Asia and Oceania   (CMAAO)

Group Editor-in-Chief IJCP Publications

President Heart Care Foundation of India

Past National President IMA