If you wish to report an adverse event or product complaint, please call 1-800-LILLYRX (1-800-545-5979)
Baqsimi™ (glucagon) nasal powder
3mgThis information is provided in response to your request. Resources may contain information about doses, uses, formulations and populations different from product labeling. See Prescribing Information above, if applicable.
Background
The physiological response to decreasing PG concentrations in a healthy individual include
a decrease in insulin secretion from the β-cell, and
an increase in glucagon secretion from the α-cell.1
In the case of β-cell failure in T1DM and advanced T2DM, a decrease in PG does not result in a decrease in insulin secretion from the β-cell. The absence of this signal results in no increase in glucagon secretion from the pancreatic α-cell during hypoglycemia.1,2
Hypoglycemia is common in individuals treated with exogenous insulin and insulin secretagogues that increase insulin concentrations regardless of the PG concentration.1-3
Figure 1. Severe Hypoglycemia is a Risk in All Individuals on Insulin, Regardless of the Type of Diabetes1,2
Abbreviations: T1D = type 1 diabetes; T2D = type 2 diabetes.
Hypoglycemia Risk Factors
Iatrogenic hypoglycemia in diabetes is related to
conventional risk factors of therapeutic hyperinsulinemia, or
risk factors due to compromised hypoglycemia defenses against falling plasma glucose concentrations.1,3
Conventional risk factors for hypoglycemia include
wrong dose, type, or dose timing of insulin, SUs, or glinides
decrease in exogenous glucose delivery due to a missed meal or fasting
decrease in endogenous glucose production, such as after alcohol intake
increase in glucose utilization, for example after exercise
increase in insulin sensitivity experienced late after exercise or with weight loss, and
decrease in insulin clearance as a result of renal failure, hepatic failure, hypothyroidism, high level of insulin-binding antibodies.3
Risk factors due to compromised hypoglycemia defenses include
absolute endogenous insulin deficiency yielding loss of the glucagon response
history of severe hypoglycemia, impaired awareness, or both, known as hypoglycemia-associated autonomic failure, and
intensive glycemic therapy and lower glycemic goal.3
1. Cryer PE. Minireview: glucagon in the pathogenesis of hypoglycemia and hyperglycemia in diabetes. Endocrinology. 2012;153(3):1039-1048. http://dx.doi.org/10.1210/en.2011-1499
2. McCrimmon RJ, Sherwin RS. Hypoglycemia in type 1 diabetes. Diabetes. 2010;59:2333-2339. http://dx.doi.org/10.2337/db10-0103
3. International Hypoglycaemia Study Group. Minimizing hypoglycemia in diabetes. Diabetes Care. 2015;38(8):1583-1591. http://dx.doi.org/10.2337/dc15-0279
Glossary
PG = plasma glucose
T1DM = type 1 diabetes mellitus
T2DM = type 2 diabetes mellitus
Date of Last Review: August 09, 2018
If you need information about a Lilly product or want to report an Adverse Event or Product Complaint, you may call us.
Available Mon - Fri, 9am - 7pm EST