Pontiroli Antonio E, Rizzo Manfredi, Tagliabue Elena
Dipartimento Di Scienze Della Salute, Università Degli Studi Di Milano, Milan, Italy.
Promise Department, School of Medicine, University of Palermo, Palermo, Italy.
Diabetol Metab Syndr. 2022 Dec 23;14(1):193. doi: 10.1186/s13098-022-00950-6.
Glucagon (traditional kits for intramuscular administration, Glucagon and Glucagen), although recommended as a remedy for severe hypoglycemia (SH), has been reported to be under-utilized, likely because of technical problems. The aims of this study were to evaluate the use of glucagon in persons with type 1 diabetes in several countries, and to investigate if the availability of new ready-to-use glucagons (Baqsimi, Gvoke, Zegalogue, years 2019 to 2021) has expanded the overall use of glucagon. The source of data was IQVIA-MIDAS (units of glucagon sold), while data on persons with type 1 diabetes in countries were derived from IDF Diabetes Atlas. The use of glucagon has been steady from 2014 to 2019, with a small but significant increase from 2019 to 2021, paradoxically only in countries where new ready-to-use glucagons were not available. The use of glucagon has always been ten fold greater in countries where new ready-to-use glucagons became available than in the other countries (population 108,000,000 vs 28,100,000, 480,291 vs 182,018 persons with type 1 diabetes). A significant correlation was observed in all years between units of glucagon and persons with type 1 diabetes. Availability of new ready-to-use glucagons was associated with a small increase of sales, due only to new ready-to-use glucagons themselves. The use of glucagon (any type) remains low, approximately 1/10 of persons with type 1 diabetes. We conclude that use of glucagon is scarce in most countries, and so far has not been expanded by new ready-to-use glucagons such as the ones considered in this study.
胰高血糖素（传统的肌内注射试剂盒，如Glucagon和Glucagen）虽被推荐作为严重低血糖（SH）的治疗药物，但据报道其使用不足，可能是由于技术问题。本研究的目的是评估几个国家中1型糖尿病患者对胰高血糖素的使用情况，并调查新型即用型胰高血糖素（Baqsimi、Gvoke、Zegalogue，2019年至2021年）的可用性是否扩大了胰高血糖素的总体使用。数据来源为IQVIA - MIDAS（销售的胰高血糖素单位），而各国1型糖尿病患者的数据则来自国际糖尿病联盟（IDF）糖尿病地图集。2014年至2019年胰高血糖素的使用一直稳定，2019年至2021年有小幅但显著的增长，矛盾的是，这种增长仅发生在没有新型即用型胰高血糖素的国家。新型即用型胰高血糖素可用的国家中胰高血糖素的使用量始终比其他国家高十倍（1型糖尿病患者人数分别为1.08亿对2810万，480291对182018人）。在所有年份中，胰高血糖素单位与1型糖尿病患者之间均观察到显著相关性。新型即用型胰高血糖素的可用性仅因其自身导致了销售额的小幅增长。胰高血糖素（任何类型）的使用仍然很低，约为1型糖尿病患者的十分之一。我们得出结论，大多数国家胰高血糖素的使用很少，到目前为止，像本研究中所考虑的新型即用型胰高血糖素尚未扩大其使用范围。
