Stenninger E, Aman J
Department of Paediatrics, Orebro Medical Centre Hospital, Sweden.
Diabetologia. 1993 Oct;36(10):931-5. doi: 10.1007/BF02374475.
The aim of the present study was to compare intra-nasal glucagon with subcutaneous glucagon as a treatment of insulin-induced hypoglycaemia in 11 children, 7-12 years old, with Type 1 (insulin-dependent) diabetes mellitus. Hypoglycaemia (1.6 +/- 0.1 vs 1.8 +/- 0.2 mmol/l) was induced twice in each child by continuous insulin and variable glucose infusions. One milligram of intranasal glucagon or 0.5 mg of subcutaneous glucagon was given in a randomized order. At 15 min after the administrations of either intranasal or subcutaneous glucagon, the blood glucose concentration increased by 1.5 +/- 0.2 mmol/l or 1.7 +/- 0.2 mmol/l above the glucose nadir, respectively. After nasal administration, the maximal rise in blood glucose was seen after 25 min. Subcutaneous injections induced higher and more sustained plasma glucagon concentrations but the children suffered more often from nausea than when they were treated intranasally. In conclusion, treatment with intranasal glucagon seems to be efficient and results in a rapid correction of insulin-induced hypoglycaemia with few side-effects.
本研究的目的是比较鼻内注射胰高血糖素与皮下注射胰高血糖素对11名7至12岁1型（胰岛素依赖型）糖尿病儿童胰岛素诱发低血糖的治疗效果。通过持续输注胰岛素和可变葡萄糖，在每个儿童身上诱发两次低血糖（血糖水平分别为1.6±0.1 vs 1.8±0.2 mmol/l）。以随机顺序给予1毫克鼻内胰高血糖素或0.5毫克皮下胰高血糖素。在给予鼻内或皮下胰高血糖素后15分钟，血糖浓度分别比血糖最低点升高1.5±0.2 mmol/l或1.7±0.2 mmol/l。鼻内给药后，25分钟时血糖出现最大升高。皮下注射诱导的血浆胰高血糖素浓度更高且更持久，但与鼻内治疗相比，儿童出现恶心的情况更频繁。总之，鼻内注射胰高血糖素治疗似乎有效，能快速纠正胰岛素诱发的低血糖，且副作用较少。
