Minimizing morbidity of hypoglycemia in diabetes: a review of mini-dose glucagon.
Minimizing morbidity of hypoglycemia in diabetes: a review of mini-dose glucagon.
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DOI：
10.1177/1932296814547518
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发表时间：
2015-01-01
影响因子：
5
通讯作者：
Haymond, Morey W
中科院分区：
文献类型：
--
作者：
Chung, Stephanie T;Haymond, Morey W
1型糖尿病是一种常见的儿童慢性病，也是最难处理的疾病之一。胰岛素制剂和胰岛素输送装置的进步显著提高了实现正常血糖稳态的能力。然而，低血糖仍然是实现正常血糖的主要限制因素，并且是急性胃肠炎和/或口服摄入不良的儿童的常见并发症。在碳水化合物摄取或吸收受损的情况下，胰高血糖素治疗是家庭和照顾者唯一可用的院外治疗选择。胰高血糖素被推荐用于治疗严重的低血糖，并通过增加肝脏糖原分解产生的葡萄糖来迅速提高血糖。小剂量胰高血糖素是一种广泛使用的非标记性治疗方法，用于控制轻微或即将发生的低血糖，并作为小剂量皮下注射使用。它最初被描述为用于无法耐受或吸收口服碳水化合物但不需要高级医疗护理的儿童。然而，小剂量的胰高血糖素对任何相对胰岛素过剩的人都是有用的。该方案旨在防止严重的低血糖发作，是安全、有效的，患者和护理人员在医院外环境下很容易给药。通过赋予患者及其家人权力，这一重要工具可以帮助减轻因即将发生的低血糖而产生的身体、心理和经济负担。
Type 1 diabetes is a common chronic disease of childhood and one of the most difficult conditions to manage. Advances in insulin formulations and insulin delivery devices have markedly improved the ability to achieve normal glucose homeostasis. However, hypoglycemia remains the primary limiting factor in achieving normoglycemia and is a frequent complication in children with acute gastroenteritis and/or poor oral intake. In situations of impaired carbohydrate intake or absorption, glucagon therapy is the only out-of-hospital treatment option available to families and caregivers. Glucagon is recommended for the treatment of severe hypoglycemia and rapidly increases blood glucose by increasing hepatic glucose production from glycogenolysis. Mini-dose glucagon is a widely utilized off-label treatment for managing mild or impending hypoglycemia and is administered as a small subcutaneous injection. It was initially described for use in children who were unable to tolerate or absorb oral carbohydrates but not in need of advanced medical care. Yet, mini-dose glucagon may be useful in any individual with relative insulin excess. The regimen aims to prevent severe hypoglycemic episodes and is safe, effective, and easily administered by patients and caregivers in the out-of-hospital setting. By empowering patients and their families, this important tool could help to alleviate the physical, psychosocial, and financial burden evolving from impending hypoglycemia.