Editor: David L. Joffe, BSPharm, CDE, FACA
Creator: Alan Martinez, PharmD Candidate, College of South Florida Taneja School of Pharmacy
Dasiglucagon is a glucagon analog with diabetes who’re six years of age and older, however how efficient is it amongst different subgroups?
Extreme hypoglycemia presents a possible danger in sufferers with diabetes, particularly amongst these with a number of therapies or those that dose an inappropriate quantity of insulin. A potential decision to deal with hypoglycemia is glucagon; sadly, this route just isn’t taken benefit of as a lot as it’s alleged to be. This drawback might stem from the reconstitution course of required when getting ready injectable glucagon, particularly when time is of utmost significance. Not like these choices, dasiglucagon is already prepared for instant use as an aqueous formulation and has successfully handled extreme hypoglycemia. Nonetheless, the effectiveness in numerous subgroups similar to intercourse, age, ethnicity, area, BMI, length of diabetes, injection website, and baseline glucose stay unclear. Due to this fact, the aim of this examine was to evaluate whether or not dasiglucagon was efficient amongst these numerous subgroups.
This examine is an built-in efficacy evaluation with knowledge from 4 trials with comparable examine situations that adopted sufferers with sort 1 diabetes who had insulin-induced hypoglycemia (n= 220). The baseline traits for this examine had proven that the majority sufferers had been non-Hispanic or Latino males with an age vary of 18 to 65 years. The first endpoint of this evaluation was the time to glucose restoration, outlined as a glucose enhance of ≥20 mg/ dL with no addition of intravenous glucose administration.
To supply the efficacy of dasiglucagon in comparison with placebo, one of many trials demonstrated that the time to glucose restoration was a median of 10 minutes [95% Confidence Interval (CI): 10 to 10] in comparison with the placebo’s 40 minutes (95% CI: 30 to 40). Moreover, the comparability between dasiglucagon and placebo confirmed that dasiglucagon dominated with a shorter time to the glucose restoration and proved to be statistically vital (P-Worth <0.001).
The primary subgroup from this built-in evaluation had in contrast the intercourse of the sufferers. Feminine (n= 91) and male (n= 129) had been equal in a median time of 10 minutes. The subgroup for age differed between sufferers ≥65 (n= 6) and people ≥18 to <65 years of age (n= 214). Whereas the sufferers between 18 and 65 years had a median time of 10 minutes to glucose restoration, the ≥65 group was quarter-hour. Nonetheless, the few sufferers within the ≥65 group hindered a correct comparability between each age teams. The identical dilemma had occurred within the ethnicity subgroup, as there have been too few Hispanic or Latino sufferers (n= 7) to non-Hispanic or Latino (n= 196); this brought about a variety of time for the Hispanic or Latino subgroup. Nonetheless, the non-Hispanic or Latino subgroup had a median time of 10 minutes, much like different outcomes. Subsequent, the area subgroup in contrast sufferers from the USA (n= 46) to those that weren’t (n= 174), and each teams had a median time of 10 minutes.
The next subgroup handled the comparability amongst totally different BMIs, <25 (n= 97), ≥25 to <30 (n= 88), ≥30 to <35 (n= 29) and ≥35 (n= 6). Subgroups <25 and ≥25 to <30 each had imply instances of 10 minutes whereas ≥30 to <35 had a barely increased worth and ≥35 had a variety attributable to fewer sufferers. The length of the diabetes subgroup consisted of <20 years of diabetes or ≥20 years of diabetes, each of which had a median time of 10 minutes. The injection website subgroup consisted of the stomach (n= 132), buttocks (n= 45), deltoid (n= 16), and thigh (n= 27), all of which shared the identical median time of 10 minutes. The ultimate subgroup was baseline glucose, each teams <54 (n= 41) and ≥54 (n= 179) had a median time of 10 minutes.
To summarize the information, dasiglucagon was enough throughout nearly all of the subgroups aside from teams the place affected person numbers had been too low to conclude. As well as, most subgroups had a imply time to glucose restoration of 10 minutes when utilizing dasiglucagon. Nonetheless, a limitation of this examine was the small pattern dimension; thus, additional analysis with a bigger pattern dimension might help the findings of this evaluation.
- The effectiveness of dasiglucagon was constant among the many numerous subgroups.
- When utilizing dasiglucagon, the bulk median time to restoration was 10 minutes.
- Dasiglucagon for extreme low blood glucose is a dependable choice in comparison with formulations the place reconstitution is required.
BATTELINO, TADEJ, et al. “345-P: The Subsequent Era Glucagon Analog Dasiglucagon Persistently Achieves Speedy Restoration from Hypoglycemia throughout Subgroups.” American Diabetes Affiliation 81st Scientific Periods. Diabetes, June 25, 2021
Alan Martinez, PharmD Candidate, College of South Florida Taneja School of Pharmacy