Philips J C, Radermecker R P, Lebrethon M C, S Scheen
Service de Diabétologie, Nutrition et Maladies métaboliques, Département de Médecine interne, CHU Liège, Belgique.
Service de Pédiatrie, CHU NDB, Liège, Belgique.
Rev Med Liege. 2022 Sep;77(9):538-543.
Patients with insulin-treated type 1 diabetes (T1D) are exposed to hypoglycaemia, which may be serious. Serious cognitive impairment (including coma and seizure) that requires the help of a third party is a medical emergency. Besides the intravenous injection of glucose by a health care provider, its treatment consists of the subcutaneous or intramuscular injection of glucagon which may be performed by a family member. However, such an injection is not easy and puts off some people, which retards the initiation of a potentially life-saving therapy. The intranasal administration of 3 mg glucagon has been shown as efficacious as the subcutaneous or intramuscular injection of 1 mg glucagon in controlled studies carried out in both adult and youth patients with T1D. Stimulation and real-life studies among caregivers, patients and acquaintances showed a preference for nasal glucagon because of its easy and quick use. The launch of nasal glucagon (Baqsimi®) offers new perspectives for the ambulatory emergency management of severe hypoglycaemia and hypoglycaemic coma with a special obvious advantage in children.
接受胰岛素治疗的1型糖尿病(T1D)患者面临低血糖风险,低血糖可能很严重。严重认知障碍(包括昏迷和癫痫发作)且需要第三方协助属于医疗急症。除了由医护人员静脉注射葡萄糖外,其治疗还包括由家庭成员进行皮下或肌肉注射胰高血糖素。然而,这种注射并不容易,会让一些人望而却步,从而延误了可能挽救生命的治疗的启动。在针对成年和青少年T1D患者开展的对照研究中,已证明鼻内给予3毫克胰高血糖素与皮下或肌肉注射1毫克胰高血糖素效果相当。在护理人员、患者及熟人中进行的模拟和实际应用研究表明,由于鼻用胰高血糖素使用方便快捷,因此更受青睐。鼻用胰高血糖素(Baqsimi®)的推出为严重低血糖和低血糖昏迷的门诊急救管理提供了新的视角,在儿童患者中优势尤为明显。