February 2018, Dr Chee L Khoo
Hypoglycaemia is one of the most common endocrine emergencies and the most feared complication of having diabetes. Treatment of severe hypoglycaemia in patients who are unable to take oral treatment is limited to either glucagon or glucose injections both of which requires some experience in playing with syringes and bottles. Dasiglucagon, a novel soluble glucagon analog, is a ready to use rescue pen developed for treatment of severe hypoglycaemia.
The instability of glucagon means that the glucagon hypo kit requires reconstitution before use. This may delay their use and may lead to underutilisation or administration errors. A majority of parents when asked to prepare for a rescue administration had handling difficulties resulting in potential suboptimal dosing.
In a study published in Diabetes Care in Dec 2017, dasiglucagon was compared with glucagon. Dasiglucagon demonstrated a dose-dependent and rapid increase in plasma concentrations, reaching a maximum at ∼35 min with a half-life of ∼0.5 h. Dasiglucagon rapidly increased plasma glucose within 6–10 min, similar to glucagon, but with a longer-lasting and greater effect on plasma glucose.
Developed by Denmark based biotech firm, Zealand Pharma, dasiglucagon recently commence patient recruitment in Phase 3 clinical trials to treat severe hypoglycaemia in patients with diabetes.
Liquid stable glucagon – the missing link?
As glucagon is not yet available in a liquid formulation, no pump systems capable of mimicking a healthy pancreas are available today. Dasiglucagon has the potential to be the first glucagon analog for chronic use in a future dual-hormone artificial pancreas.
The firm is in the process of developing another dasiglucagon formulation for use in congenital hyperinsulinism treatment.
Exciting times ahead.
Access abstract here
Ulrike Hövelmann, Britta Væver Bysted, Ulrik Mouritzen, Francesca Macchi, Daniela Lamers, Birgit Kronshage, Daniél Vega Møller and Tim Heise. Pharmacokinetic and Pharmacodynamic Characteristics of Dasiglucagon, a Novel Soluble and Stable Glucagon Analog. Diabetes Care 2017 Dec; dc171402