Home Use of Mini-Dose Glucagon As a Novel Treatment for Hypoglycemia Following Repeated, Prolonged Fasts in Type 1 Diabetes During Ramadan

Diabetes Care. 2022 Apr 1;45(4):990-993. doi: 10.2337/dc21-1655.

Abstract

Objective: We determined the efficacy of self-administered subcutaneous mini-dose glucagon (MDG) to treat fasting-induced hypoglycemia in type 1 diabetes (T1D).

Research design and methods: This was a 4-week randomized, controlled crossover trial of 2-week MDG or 2-week oral glucose tablets (OG, control) involving 17 adults with T1D during Ramadan.

Results: Compared with OG, MDG demonstrated a significant higher change in blood glucose from baseline to 30 min (Δt30, P < 0.001) and 1 h (Δt60, P = 0.02). The efficacy of MDG was preserved following ≥8 h fasting with significantly higher Δt30 in MDG (P = 0.01). Over the entire 2 weeks, MDG period had increased time in 70-180 mg/dL (P = 0.009) and less time <70 mg/dL (P = 0.04). MDG use resulted in higher completion of fasts compared with OG (P < 0.001).

Conclusions: MDG administration is an effective alternative to OG for prevention and treatment of fasting-induced hypoglycemia, offering improved glycemic control and promoting successful completion of prolonged fasts.

Trial registration: ClinicalTrials.gov NCT03970772.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Blood Glucose
  • Diabetes Mellitus, Type 1* / drug therapy
  • Fasting
  • Glucagon
  • Humans
  • Hypoglycemia* / chemically induced
  • Hypoglycemic Agents / adverse effects
  • Insulin

Substances

  • Blood Glucose
  • Hypoglycemic Agents
  • Insulin
  • Glucagon

Associated data

  • ClinicalTrials.gov/NCT03970772
  • figshare/10.2337/figshare.18857882