Stable Liquid Glucagon: Beyond Emergency Hypoglycemia Rescue.
Stable Liquid Glucagon: Beyond Emergency Hypoglycemia Rescue.
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DOI：
10.1177/1932296818757795
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发表时间：
2018-07-01
影响因子：
5
通讯作者：
Castle, Jessica R
中科院分区：
文献类型：
--
作者：
Wilson, Leah M;Castle, Jessica R
血糖控制是以增加低血糖风险为代价的预防糖尿病并发症的主要手段。严重的低血糖会对1型糖尿病患者的生活质量产生负面影响，并可能导致发病率和死亡率。目前可用的胰高血糖素急救包在正确使用的情况下对治疗低血糖是有效的，但是使用起来很复杂，特别是对未经培训的人。需要更好的胰高血糖素治疗低血糖的配方和设备，特别是稳定的液体胰高血糖素。在本综述的范围之外，稳定型液体胰高血糖素的其他潜在用途包括先天性高胰岛素症、减肥手术后低血糖和胰岛素瘤诱导的低血糖。35年来，美国食品和药物管理局（FDA）批准了第一个液体稳定的人重组胰岛素，我们继续等待胰高血糖素的对应物。对于轻度低血糖，市售的液体稳定型胰高血糖素可以更广泛地应用于小剂量胰高血糖素以及双激素闭环系统。本文综述了胰高血糖素在1型糖尿病治疗中的当前和未来的药物应用，并展望了稳定的胰高血糖素液体制剂，有望在不久的将来用于患者。
Glycemic control is the mainstay of preventing diabetes complications at the expense of increased risk of hypoglycemia. Severe hypoglycemia negatively impacts the quality of life of patients with type 1 diabetes and can lead to morbidity and mortality. Currently available glucagon emergency kits are effective at treating hypoglycemia when correctly used, however use is complicated especially by untrained persons. Better formulations and devices for glucagon treatment of hypoglycemia are needed, specifically stable liquid glucagon. Out of the scope of this review, other potential uses of stable liquid glucagon include congenital hyperinsulinism, post-bariatric surgery hypoglycemia, and insulinoma induced hypoglycemia. In the 35 years since Food and Drug Administration (FDA) approval of the first liquid stable human recombinant insulin, we continue to wait for the glucagon counterpart. For mild hypoglycemia, a commercially available liquid stable glucagon would enable more widespread implementation of mini-dose glucagon use as well as glucagon in dual hormone closed-loop systems. This review focuses on the current and upcoming pharmaceutical uses of glucagon in the treatment of type 1 diabetes with an outlook on stable liquid glucagon preparations that will hopefully be available for use in patients in the near future.