Researchers Pit Mini-dose Glucagon Vs. Carbs to Treat Lows


Glucagon is currently considered the hypodermic of last resort – relegated to the back of the fridge in case of an emergency. In recent years, however, there have been research efforts to bring glucagon more to the forefront of Type 1 treatment. Those efforts have focused on reformulating glucagon to be stable at room temperature, and on testing if mini-doses of glucagon can be effective in combating less severe dips in blood glucose levels. Both avenues of research are important to explore if glucagon if is to be part of a future automated insulin delivery pump system.

This past year, the T1D Exchange conducted a study entitled “Mini-dose Glucagon to Treat Non-severe Hypoglycemia in Adults with Type 1 Diabetes”. Researchers conducted the study to see if a mini-dose of glucagon works as well or better than carbohydrate treatments to treat non-severe hypoglycemia.. Here is what the researchers reported:

The study enrolled 26 participants at 5 diabetes centers across the United States. Participants treated hypoglycemia with mini-dose glucagon (150µg, Xeris Pharmaceuticals, Inc.) during one period of the main trial and with oral glucose tablets (16g) during the other period. About half the participants started with mini-dose glucagon and the other half started with glucose tablets.

The success rate for treatment of non-severe hypoglycemia was not different between treatments—94% of hypoglycemic events during the mini-dose glucagon period and 95% of events during the glucose tablets period were successfully treated. See graph below.


In conclusion, small doses of glucagon can successfully treat mild-to-moderate hypoglycemia. It may be a useful alternative to treatment with oral glucose tablets, especially when feeling sick or trying to avoid taking in more calories.

We often hear about research when it proves something is better than the existing therapy. Often, however, if a new treatment is to be granted FDA approval, it must first prove that it is as safe and effective as existing treatment options. This study was a step forward for mini-glucagon researchers, and it shows that in the future there may be another treatment option for combatting mild hypoglycemia.

-Craig Idlebrook


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