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New mini-dose glucagon product in development?

Discussion in 'Parents of Children with Type 1' started by buggle, Dec 11, 2011.

  1. buggle

    buggle Approved members

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    I was taking the Diabtribe survey yesterday and there was a question that talked about a new product for treating lows -- a mini-dose glucagon that would be delivered in a pen, like insulin pens, where you could precisely dose for lows in place of eating sugar. They described the product and then asked how likely we'd be to buy it and how often we would potentially use it.

    It sounds interesting. It'd be great to give our kids a shot in the night when they're low and not have to wake them to give them sugar. They also seem to be targeting it towards people concerned about weight gain from extra calories from treating lows.

    Has anyone heard of this product? I wonder if it's really coming out and if so, when it would be available.
     
  2. Ndiggs

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    sounds interesting, but my question would be storage of the gulcagon mixed. If I remember right the info for glucagon says it is good in a mixed state for 24 hours before it starts to break down. It would be interesting to see the stats on this new product to see if/how they overcome that.

    To answer the original question though I would love the product, as tonight I think its going to be one of those nights where we are low all night no matter what we do, 35g uncovered brought us up 5 whole points over 90 minutes, lol
     
  3. TheFormerLantusFiend

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    I filled out a survey about it last year. Here's a CWD thread about it from about a year and a half ago: http://forums.childrenwithdiabetes.com/showthread.php?t=55141

    Here's an article about why it's not on the market yet: http://asweetlife.org/a-sweet-life-staff/featured/glucapen-the-way-glucagon-ought-to-be/19238/

    Basically, they have a product, but it still needs to pass FDA screenings, and that will take money the company does not have. They are using a type of glucagon that is being used in Europe that has not been approved here.
     
  4. Ndiggs

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    Ok, I may be mis-understanding here, but I thought the OP was referring to a pen like set-up (a la humalog or novalog pen) that would allow us as parents to dose 1, 2, 22, 222 units of glucagon to correct a low versus ingesting carbs for like overnight lows.

    I have seen the glucagon emergency pen (love it btw and want one now) but I believe that delivers a set dose just as an epi pen does, so I thought we were talking about two different products. The Glucapen from what I have read still has the products separate and mixed just before injection. For a mini injection pen to work I would imagine it would have to be a stable form of liquid glucagon, which I think is part of the problem getting a full closed loop working as it is not stable longterm like insulin.
     
  5. buggle

    buggle Approved members

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    This is like a novopen. I can't remember how the question was structured -- there were a ton of questions on the survey -- but they usually ask a series of questions about what would be important in a product. One question asked if it were important that it last for a month or more. Come to think of it, maybe it was one of those ranking questions, where you drag items in order of importance.

    This isn't an emergency product. You'd carry it around with you and dose for lows -- kind of like a manual AP. You could give yourself a precise dose based on your BG number in place of popping a glucose tablet.
     
  6. Style mom

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    My kid would rather eat 400 tabs than get a shot. It would be a complete nonstarter here.
     
  7. Sarah Maddie's Mom

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    I don't know... on the face of it it's not very attractive. Why would I want to tax my kid's liver's glucose supply ( which, as far as I know, is unmeasurable) to treat a run of the mill low when a 60 calorie juice box and maybe a reduced basal rate might do the same?;)
     
  8. buggle

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    It's probably going to be targeted to adult and teen T1's who are worried about gaining weight. I'm only guessing based on the description and the questions that were asked. This product could be in development now or one of the companies may have been trying to float the idea to see how people react.

    Is anyone else in the Diatribe survey group? They ask a lot of questions. Every so often, there's a good one. I loved when they gave a list the diabetes product companies and let you choose one then write as long a note as you wanted to the CEO. They couldn't guarantee that the CEO would read it, but they said there was a pretty good chance! :p Usually, though, they're just gathering info about products for the companies. It's nice to be able to give feedback.
     
  9. buggle

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    That's really how the AP is supposed to work -- a reservoir of insulin and one of glucagon to balance BG. Though I don't hear that much anymore now that they're calling the integrated pump/CGM the AP.
     
  10. Sarah Maddie's Mom

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    I do wish they would drop the whole "AP" thing and just call it a "closed loop pump" :rolleyes: it would be so much more honest. And don't forget, it may well be two sensors, not just one ...
     
  11. Ndiggs

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    Yeah, last I heard was a Russian group that was starting trials on that system, but the glucagon had to be changed ever 12 hours or something unreasonable like that. I think once that there is shelf stable glucagon we will see more work towards the insulin/glucagon system.

    I am a fan of this mini pen idea myself as releasing small ammounts of glucagon is the bodies way of stabalizing blood sugars, so if can at 2 am (provided I have already done a pettry agressive temp basil ect) have a pen to give Olivia a half unit or a unit of glucagon to help keep her in her target range overnite and not have to keep craming carbs into her, I am all for that. Think of the dental savings down the road :D Mostly I just feel bad waking her up all the time on nights like that to get carbs into her, the next day is pettry rough on her.
     
  12. TheFormerLantusFiend

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    They trialed a glucagon + insulin closed loop system in Washington state. You can read the results on clinicaltrials.gov. Search glucagon.
     
  13. Ndiggs

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    nice! I will have to look that one up, I was not aware of that trial. Thanks
     
  14. bradclark

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    Correct me if I'm wrong, but it's my understanding that glucagon triggers the liver to release stored sugar into the bloodstream. So, my question is how often can this be administered before the store runs dry. Would there have to be a minimum amount of time between doses, depending upon how much you utilize?
     
  15. Ndiggs

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    From what I understand, the body stores roughly 24 hours worth of glcuose in the liver. When our daughter was sick last year with the flu and we could not get sugars up, our endo had us mix up a bottle of glucagon and inject 1-4 units 2 hours after each meal if she was not absorbing carbs (which she did not do for 2 days) We had good results until day 3 when stores were used up, and she was just not getting enough in for the body to replenish the stores. So I am thinking in a normal case (65 at night check for example) you would see little difference in the stored amount in the body.

    In a person with a healthy pancreas, the alpha cells would secrete glucagon while the beta cells would secrete insulin. It it thought that the there are insulin receptors in the alpha cells that help balance glucagon secretion and these may not work as well on insulins available now (hence why we see hypos) If this is the case, a small dose of glucagon would work more closely to how the pancreas does now.

    I know Joslin had a few articles a couple of years ago where they did a study with mice. I will see if I can find the .pdf of it.
     
  16. TheFormerLantusFiend

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    There is a study currently enrolling type 1 pump users, age 21-65 as participants to try to figure out what exactly determines whether glucagon will provoke a significant rise in blood sugar.
    According to the study (which is being funded by the JDRF) about 1 in 4 times that glucagon is given in one of their studies, it hasn't worked.

    http://clinicaltrials.gov/ct2/show/NCT01483651
     

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