Visual Abstract
Objective: To compare the efficacy of low-dose s.c. dasiglucagon to oral carbohydrate consumption for prevention of insulin-induced hypoglycemia in people with type 1 diabetes.
Methods: Twenty adults with type 1 diabetes using either multiple daily injection or insulin pump therapy completed a randomized, 3-arm cross-over study. On each study visit, an individualized s.c. insulin bolus was administered aiming for a plasma glucose concentration (PG) of 3.0 mmol/L. When reaching a PG of 4.5 mmol/L, either 80 µg dasiglucagon (D80), 120 µg dasiglucagon (D120) or 15 g carbohydrates from dextrose tablets (CHO) were administered. PG was measured frequently for the following 180 minutes.
Results: Ten participants with CHO, 5 with D80 and 4 with D120 experienced a PG less than 3.9 mmol/L during the study (McNemar: CHO vs. D80, p=0.096; CHO vs. D120, p=0.034). The median time (95%CI) from intervention to first increase in PG of 1.1 mmol/L was 30 (25-50), 15 (15-20) and 15 (15-20) minutes for CHO, D80 and D120 (log-rank: CHO vs. D80, p=0.006; CHO vs. D120, p=0.003). No significant differences in visual analog scale-assessed expected adverse effects were observed between interventions.
Conclusion: Low-dose dasiglucagon effectively prevented insulin-induced hypoglycemia with a faster glucose-elevating profile than dextrose tablets.
C. Laugesen: None. A. Ranjan: None. S. Schmidt: None. K. Nørgaard: Advisory Panel; Self; Medtronic, Other Relationship; Self; Novo Nordisk Inc., Zealand Pharma A/S, Speaker’s Bureau; Self; Medtronic.
