Being Developed: Nasal Delivery of Glucagon for Hypoglycemia
Glucagon that can be administered via the nose is being developed, and may help alleviate anxiety about severe hypoglycemia (low blood sugar) for those with type 1 diabetes.
Nasal glucagon powder does not have to be consciously inhaled - it is absorbed passively in the nasal passage - so can easily be given to awake or unconscious individuals. The powder is placed in the nasal passage by pressing a plunger on the delivery mechanism.
“We [clinicians] frequently get phone calls for severe hypoglycemia, and people haven’t treated it because they don’t know where the [glucagon] kit is, and so I think this makes the potential treatment much easier for parents, schoolteachers, bus drivers—anybody can do it,” said Dr. Jennifer Sherr, Yale School of Medicine.
Ease of Use
The fear of blood sugar dropping too low prevents some with type 1 diabetes from attaining healthy glucose targets. Researchers hope that intranasal glucagon will remove this barrier to better health.
Currently, glucagon must be reconstituted before giving it by intramuscular injection. Though parents typically become adept at this procedure, children with type 1 diabetes are frequently cared for by school personnel, grandparents, siblings, and babysitters who may be less confident or knowledgeable about glucagon administration.
However, even untrained acquaintances can successfully provide treatment with intranasal glucagon. According to initial studies it is given more quickly and with significantly fewer errors than the intramuscular version, by either caregivers or “good Samaritan” bystanders.
Another intranasal plus is a delivery system that differs from giving insulin by injection, lowering the risk of accidental insulin administration in a low blood sugar emergency.
Remaining Questions
Although a promising treatment for hypoglycemia, there are still questions about intranasal glucagon that require answers, such as the exact mechanism by which it is absorbed, and how many doses can be given depending on blood sugar levels. Differences in human nasal mucosa during developmental stages, or during times of infection need to be studied as well.
A Canadian company is developing intranasal glucagon and plans to file a U.S. new drug application in 2016.
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