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

• DOI: 10.2337/dc21-1655
• Publication Date: 2022-02-17T14:46:40Z
• Authors: Metab Algeffari; Sufyan Hussain; Turki Almogbel; Mansour Alsharidah; Habibah Alghadouni; Farid Mahmood
• Keywords: Adult; Blood Glucose; 610; Fasting; Glucagon; Hypoglycemia; 3. Good health; Novel Communications in Diabetes; 03 medical and health sciences; Diabetes Mellitus, Type 1; 0302 clinical medicine; Humans; Hypoglycemic Agents; Insulin

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.