Department of Pediatrics, Division of Pediatric Endocrinology and Diabetes, Stanford University School of Medicine, Palo Alto, California, USA.
Department of Pediatric Endocrinology and Diabetes, Yale School of Medicine, New Haven, Connecticut, USA.
Pediatr Diabetes. 2022 Sep;23(6):754-762. doi: 10.1111/pedi.13360. Epub 2022 May 24.
Prompt and reliable management of hypoglycemia in youth with diabetes is important to prevent serious medical complications.
To determine efficacy, pharmacodynamics (PD), pharmacokinetics (PK), safety, and tolerability of a ready-to-use, liquid stable glucagon formulation administered subcutaneously via an autoinjector pen to youth with type 1 diabetes (T1D).
After plasma glucose concentration was < 80 mg/dL (< 4.4 mmol/L) after insulin, participants aged 2 to < 12 years with T1D were administered 0.5 mg of glucagon; participants aged 12 to < 18 years instead received 1 mg of glucagon. Then, adolescents were challenged with 0.5 mg after a 7- to 28-day washout period. Primary endpoint was mean plasma glucose concentration at 30 min after glucagon.
Plasma glucose concentrations significantly (p < 0.001) increased from baseline to 30 min after glucagon, with mean change in plasma glucose concentration between baseline and 30 min for each age cohort as follows: 2 to < 6 years (n = 7; 81.4 mg/dL [4.5 mmol/L]); 6 to < 12 years (13; 84.2 mg/dL [4.7 mmol/L]); 12 to < 18 years (11; dose, 1 mg; 54.0 mg/dL [3.0 mmol/L]); and 12 to < 18 years (11; 0.5 mg; 52.4 mg/dL [2.9 mmol/L]). Among age cohorts, no clinically relevant differences were observed for PD and PK parameters. Common adverse events were nausea, vomiting, and hypoglycemia.
Age-appropriate dosing of this glucagon formulation was effective at 30 min in reversing plasma glucose concentrations from < 80 mg/dL in youth with T1D.
及时、可靠地管理青少年糖尿病患者的低血糖症对于预防严重的医疗并发症至关重要。
评估一种预充式、液体稳定的胰高血糖素皮下注射笔在治疗 1 型糖尿病(T1D)青少年患者中的疗效、药效学(PD)、药代动力学(PK)、安全性和耐受性。
在胰岛素治疗后血糖浓度<80mg/dL(<4.4mmol/L)后,年龄在 2 岁至<12 岁的 T1D 患者给予 0.5mg 胰高血糖素;年龄在 12 岁至<18 岁的患者给予 1mg 胰高血糖素。然后,在 7-28 天洗脱期后,青少年接受 0.5mg 胰高血糖素挑战。主要终点为胰高血糖素给药后 30 分钟的平均血浆葡萄糖浓度。
与基线相比,胰高血糖素给药后 30 分钟时血糖浓度显著升高(p<0.001),每个年龄组的基线至 30 分钟的平均血浆葡萄糖浓度变化如下:2 岁至<6 岁(n=7;81.4mg/dL [4.5mmol/L]);6 岁至<12 岁(n=13;84.2mg/dL [4.7mmol/L]);12 岁至<18 岁(n=11;剂量 1mg;54.0mg/dL [3.0mmol/L]);和 12 岁至<18 岁(n=11;0.5mg;52.4mg/dL [2.9mmol/L])。在各年龄组中,PD 和 PK 参数无临床相关差异。常见的不良反应是恶心、呕吐和低血糖。
该胰高血糖素制剂在各年龄组中均可有效在 30 分钟内逆转 T1D 青少年<80mg/dL 的血糖浓度。