Epipen as an alternative to glucagon in the treatment of hypoglycemia in children with diabetes

Diabetes Care
T P MonsodJ A Ahern

Abstract

Fear of a severe hypoglycemic reaction is a major obstacle to achieving near-normal plasma glucose levels. Although parenteral glucagon is effective in treating these reactions, it is cumbersome to use, causes severe nausea, and is impractical in the school setting. Epinephrine is available as a premixed injection (Epipen) that may be used by all care providers. Using Epipen to treat hypoglycemia may be an effective, safe, and easy-to-use alternative to glucagon. Ten children (age 11.7 +/- 2.4 years) with type 1 diabetes were studied on two occasions. After an overnight equilibration period, hypoglycemia was induced via an insulin pump (1 mU x kg(-1) x min(-1)). At a blood glucose level of 2.8 mmol/l, either glucagon (1 mg) or epinephrine (0.3 mg), in random order, was administered intramuscularly and responses were monitored. Plasma free insulin concentrations were similar in both studies. Plasma glucose levels increased by 1.7 +/- 0.2 mmol/l (mean +/- SEM) in 10 min and by 2.6 +/- 0.2 mmol/l in 15 min with administration of glucagon and were not consistently increased with administration of epinephrine (P < 0.01). Peak glucagon concentrations after administration of glucagon were >60-fold higher than basal concentrations. Aft...Continue Reading

References

Dec 1, 1991·The American Journal of Physiology·P De FeoG B Bolli
Jun 6, 1998·The New England Journal of Medicine·T W JonesW V Tamborlane
Aug 1, 1955·The Journal of Pediatrics·M J CARSON, R KOCH

❮ Previous
Next ❯

Citations

Oct 25, 2007·Pediatric Research·Luisa M RodriguezRubina A Heptulla
Mar 3, 2007·Southern Medical Journal·Patrick J Boyle, John Zrebiec
Aug 21, 2010·Endocrinology and Metabolism Clinics of North America·Tandy AyeBruce Buckingham

❮ Previous
Next ❯

Related Concepts

Related Feeds

American Diabetes Association Journals

Discover the latest diabetes research published by the journals from the American Diabetes Association.

Autoimmune Diabetes & Tolerance

Patients with type I diabetes lack insulin-producing beta cells due to the loss of immunological tolerance and autoimmune disease. Discover the latest research on targeting tolerance to prevent diabetes.