Intranasal glucagon was extremely effective in treating insulin-induced hypoglycemia in adults with type 1 diabetes in an 8-center randomized crossover noninferiority trial involving 75 adults.

Participants averaged 33 years of age and had type 1 diabetes for an average of 18 years. Investigators compared 3 mg intranasal vs 1 mg intramuscular (IM) glucagon for hypoglycemia induced by intravenous insulin. Plasma glucose at baseline averaged 48 and 49 mg/dL at the intranasal and IM visits, respectively. Researchers defined success as an increase to ≥70 mg/dL or ≥20 mg/dL from the glucose low point within 30 minutes.

Among the results:

• Treatments were successful in all but 1 intranasal visit and all IM visits.

• Average time to success: 16 minutes for intranasal, 13 minutes for IM.

• Head/facial discomfort was reported during one-fourth of intranasal and 9% of IM visits; nausea occurred in 35% of intranasal and 38% of IM visits.

Citation: Rickels M, Ruedy K, Foster N, et al. Intranasal glucagon for treatment of insulin-induced hypoglycemia in adults with type 1 diabetes: A randomized crossover noninferiority study. Diabetes Care. 2016;39(2):264-270. doi:10.2337/dc15-1498.