Mini-Dose Glucagon as a Novel Approach to Prevent Exercise-Induced Hypoglycemia in Type 1 Diabetes

Diabetes Care
Michael R RickelsT1D Exchange Mini-Dose Glucagon Exercise Study Group

Abstract

Patients with type 1 diabetes who do aerobic exercise often experience a drop in blood glucose concentration that can result in hypoglycemia. Current approaches to prevent exercise-induced hypoglycemia include reduction in insulin dose or ingestion of carbohydrates, but these strategies may still result in hypoglycemia or hyperglycemia. We sought to determine whether mini-dose glucagon (MDG) given subcutaneously before exercise could prevent subsequent glucose lowering and to compare the glycemic response to current approaches for mitigating exercise-associated hypoglycemia. We conducted a four-session, randomized crossover trial involving 15 adults with type 1 diabetes treated with continuous subcutaneous insulin infusion who exercised fasting in the morning at ∼55% VO2max for 45 min under conditions of no intervention (control), 50% basal insulin reduction, 40-g oral glucose tablets, or 150-μg subcutaneous glucagon (MDG). During exercise and early recovery from exercise, plasma glucose increased slightly with MDG compared with a decrease with control and insulin reduction and a greater increase with glucose tablets (P < 0.001). Insulin levels were not different among sessions, whereas glucagon increased with MDG administratio...Continue Reading

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Citations

Sep 26, 2019·Diabetes Therapy : Research, Treatment and Education of Diabetes and Related Disorders·Rikke TetzschnerKirsten Nørgaard
Nov 13, 2019·The Journal of Clinical Endocrinology and Metabolism·Christopher M MullaMary Elizabeth Patti
Dec 1, 2019·Experimental Physiology·E J CockcroftR C Andrews
Sep 8, 2019·Current Diabetes Reports·Colin P HawkesMichael R Rickels
Feb 19, 2020·Diabetes Technology & Therapeutics·Satish K GargIrl B Hirsch
Jun 14, 2020·Diabetologia·Michael C RiddellRichard M Bracken
Jan 26, 2020·Endocrinology and Metabolism Clinics of North America·Leah M WilsonJessica R Castle
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Nov 24, 2020·Diabetes Spectrum : a Publication of the American Diabetes Association·Justin J Sherman, Jessica L Lariccia

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