New Developments in Glucagon Treatment for Hypoglycemia.
New Developments in Glucagon Treatment for Hypoglycemia.
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胰高血糖素治疗低血糖的新进展。
DOI：
10.1007/s40265-022-01754-8
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发表时间：
2022
期刊：
影响因子：
11.5
通讯作者：
Wilson,LeahM
中科院分区：
文献类型：
--
作者：
Story,LesleAnnHayward;Wilson,LeahM
胰高血糖素与配对激素胰岛素对于内源性葡萄糖调节至关重要。与胰岛素不同，胰高血糖素的药物用途由于肽的不稳定性质而受到限制。胰高血糖素有潜力解决低血糖这一糖尿病治疗的主要限制因素，低血糖在 1 型和 2 型糖尿病中仍然很常见。最近的发展有望改变这种模式，并扩大胰高血糖素在糖尿病患者中的使用。胰高血糖素急救包在治疗严重低血糖方面有很大的局限性。复杂的重构和注射过程常常导致给药不完整或中止。新制剂包括带有易于使用的无针鼻涂药器的鼻内胰高血糖素，以及预填充注射装置中的两种稳定的液体制剂。这些可能会减轻严重低血糖治疗的负担。液体制剂也可能在治疗非严重低血糖方面发挥作用。尽管扩大使用胰高血糖素有潜在的好处，但不良副作用（恶心、呕吐）、成本和添加另一种药物的复杂性可能会限制现实世界的使用。此外，在提供者建议广泛、频繁使用胰高血糖素之前，需要更多的长期安全性和结果数据。
Glucagon is essential for endogenous glucose regulation along with the paired hormone, insulin. Unlike insulin, pharmaceutical use of glucagon has been limited due to the unstable nature of the peptide. Glucagon has the potential to address hypoglycemia as a major limiting factor in the treatment of diabetes, which remains very common in the type 1 and type 2 diabetes. Recent developments are poised to change this paradigm and expand the use of glucagon for people with diabetes. Glucagon emergency kits have major limitations for their use in treating severe hypoglycemia. A complicated reconstitution and injection process often results in incomplete or aborted administration. New preparations include intranasal glucagon with an easy-to-use and needle-free nasal applicator as well as two stable liquid formulations in pre-filled injection devices. These may ease the burden of severe hypoglycemia treatment. The liquid preparations may also have a role in the treatment of non-severe hypoglycemia. Despite potential benefits of expanded use of glucagon, undesirable side effects (nausea, vomiting), cost, and complexity of adding another medication may limit real-world use. Additionally, more long-term safety and outcome data are needed before widespread, frequent use of glucagon is recommended by providers.