Mini-glucagon

That’s what the Phase 2a trial of dasigucagon from Zealand Pharma tested. The apparent answer, so far was yes to everything: the glucose response was proportional to the injection.

I think Zealand Pharma is clearly going for the mini-gluc configuration, with its deal with the Boston dual-pump concern. Their phase 2a trial specifically goes after that. But I don’t see any sign from Xeris there.

I don’t think your liver always responds the same way, but what we’ve noticed with the mini-glucagon when Samson was sick is that it was *fast. We did notice it was fairly dose-dependent. 3 units would raise him 30 to 50 points. 4 units would raise him 40 to 70, etc.
Glucagon seemed to work within 10 minutes *on Dexcom. So fast.
So I could imagine using it like so: Right now, we have thresholds like treat with carbs at 95 sideways arrow down. We could use glucagon at those thresholds and if in 10 or 15 minutes he’s still dropping then we could give carbs at less than 80. This would translate to a lot fewer carb corrections.

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I think the danger would be - your liver only has a limited quantity. The average 150 pound male has 1,800 calories of storage:

  • Muscle glycogen: 1400 calories
  • Liver glycogen: 320 calories
  • Glucose in plasma and body fluids: 80 calories
  • Total: = 1800 calories

Imagine someone who keeps going low and instead of eating, relies on their glucagon to bail them out. This is easy to envision - busy people, working, driving, doing whatever, not stopping to eat.

After awhile, they are screwed! If they don’t eat to replace it, that liver glycogen is used up.

After every glucagon shot I ever got, my parents would always make me eat to replace. They were very smart in that way.

Here are the listings for the Phase III Trials on ClinicalTrials.gov

And here’s an interesting, just-completed one on exercise-induced hypoglycemia, @Eric . Not sure if they’ll publish the results, but I would be very curious to see how the mini-gluc affected exercise-induced lows.

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sure, people could use it in a dumb way. People also avoid taking insulin to lose weight, or drink soylent to avoid eating, etc.
I guess the question is if the common-sense, useful way to use it would actually improve peoples’ lives. For us, there’s no doubt the answer is yes.

I think it is a question of patient education.

I’ve been somewhat following these guys for a couple of years. The development of this form of glucogon could really help them reach their goal.

https://99designs-56f5b0ac3db52.jimdo.com

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Doc, I think you should do a new thread on them!

Ok. I can probably get to it later tonight.

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