Canada: Mini-dose glucagon with or without a 50% reduction in CSII (continuous subcutaneous insulin infusion) basal delivery rate may decrease exercise-associated hypoglycemia (EAH) incidence in patients with type 1 diabetes, says a recent study. The study’s findings appeared in the journal Diabetes Care on January 23 2023.
Glucagon is the standard of care for hypoglycaemia treatment. Ronnie Aronson from LMC Diabetes & Endocrinology in Toronto, Ontario, Canada, and colleagues aimed to determine the effect of ready-to-use, mini-dose glucagon on the incidence of exercise-associated hypoglycemia in adults with type 1 diabetes.
The patients initially participated in the in-clinic training phase for which they were randomly allocated to 150 µg glucagon labelled as treatment arm A or placebo labelled as arm B subcutaneously in a crossover design immediately before exercise, plus a 50% reduction in continuous SC insulin infusion basal delivery rate. Then the completers were randomly assigned in the outpatient investigational phase of 12 weeks: arm A, B, or open-label C, 150 µg glucagon alone.
The patients, in real-world settings, performed their usual aerobic exercise with moderate to high intensity for 30 to 75 min. Data analysis was done for the level 1 hypoglycemia incidence based on self-monitoring blood glucose and several exploratory and secondary endpoints.
The authors reported the following findings:
“In adults with type 1 diabetes, mini-dose glucagon with or without a 50% reduction in CSII basal delivery rate may help to decrease the incidence of exercise-associated hypoglycemia,” the researchers concluded.
Ronnie Aronson, Michael C. Riddell, Valentina Conoscenti, M. Khaled Junaidi; Effect of Mini-Dose Ready-to-Use Liquid Glucagon on Preventing Exercise-Associated Hypoglycemia in Adults With Type 1 Diabetes. Diabetes Care 2023; dc221145.
Dr Kartikeya Kohli is an Internal Medicine Consultant at Sitaram Bhartia Hospital in Delhi with super speciality training in Nephrology. He has worked with various eminent hospitals like Indraprastha Apollo Hospital, Sir Gangaram Hospital. He holds an MBBS from Kasturba Medical College Manipal, DNB Internal Medicine, Post Graduate Diploma in Clinical Research and Business Development, Fellow DNB Nephrology, MRCP and ECFMG Certification. He has been closely associated with India Medical Association South Delhi Branch and Delhi Medical Association and has been organising continuing medical education programs on their behalf from time to time. Further he has been contributing medical articles for their newsletters as well. He is also associated with electronic media and TV for conduction and presentation of health programs. He has been associated with Medical Dialogues for last 3 years and contributing articles on regular basis.
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