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Home Use of Mini-Dose Glucagon As a Novel Treatment for Hypoglycemia Following Repeated, Prolonged Fasts in Type 1 Diabetes During Ramadan

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Metab Algeffari, Sufyan Hussain, Turki Almogbel, Mansour Alsharidah, Habibah Alghadouni, Farid Mahmood

Original languageEnglish
Pages (from-to)990-993
Number of pages4
JournalDiabetes Care
Issue number4
Early online date17 Feb 2022
Accepted/In press20 Jan 2022
E-pub ahead of print17 Feb 2022
Published1 Apr 2022

Bibliographical note

Funding Information: The project was supported by grants from Qassim University (Agreement No. 5389-med-2019-2-2-I). Funding Information: Acknowledgments. The clinical trials were carried out at Qassim University Outpatient Clinics and Diabetes and Endocrinology Center at King Fahd Specialist Hospital in Buraydah. The authors thank the study participants, the research nurses, and the study coordinator for contribution in execution of this study. The authors thank Dr. Nazim Ghouri for his advice and suggestions on preparing the manuscript. The authors gratefully acknowledge Qassim University, represented by the Deanship of Scientific Research, on the financial support for this research under the number 5389-med-2019-2-2-I during the academic year 2019. The authors also thank the Research Unit at Buraydah Diabetes and Endocrinology Center, Buraydah, Saudi Arabia, for assisting and supporting the conduct of this clinical trial. Funding. The project was supported by grants from Qassim University (Agreement No. 5389-med-2019-2-2-I). Duality of Interest. S.H. reports personal fees from Novo Nordisk, outside the submitted work. No other potential conflicts of interest relevant to this article were reported. Author Contributions. M.A. and S.H. contributed to data interpretation, wrote and edited the manuscript, and revised its intellectual and technical content. T.A., M.A., and H.A. reviewed and edited the manuscript. F.M. performed statistical analyses and edited the manuscript. M.A. is the guarantor of this work and, as such, had full access to all the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis. Prior Presentation. Parts of this study were presented as an oral presentation at the 14th International Conference on Advanced Technologies and Treatments for Diabetes (ATTD), Paris, France, 2–5 June 2021. Publisher Copyright: © 2022 by the American Diabetes Association.


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We determined the efficacy of self-administered subcutaneous mini-dose gluca-gon (MDG) to treat fasting-induced hypoglycemia in type 1 diabetes (T1D). RESEARCH DESIGN AND METHODS This was a 4-week randomized, controlled crossover trial of 2-week MDG or 2-week oral glucose tablets (OG, control) involving 17 adults with T1D during Ramadan. RESULTS Compared with OG, MDG demonstrated a significant higher change in blood glucose from baseline to 30 min (∆ t30, P < 0.001) and 1 h (∆ t60, P = 0.02). The efficacy of MDG was preserved following ≥8 h fasting with significantly higher ∆ t30 in MDG (P = 0.01). Over the entire 2 weeks, MDG period had increased time in 70–180 mg/dL (P = 0.009) and less time <70 mg/dL (P = 0.04). MDG use resulted in higher completion of fasts compared with OG (P < 0.001). CONCLUSIONS MDG administration is an effective alternative to OG for prevention and treatment of fasting-induced hypoglycemia, offering improved glycemic control and promoting successful completion of prolonged fasts.

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