Role of Glucagon in Automated Insulin Delivery

Endocrinol Metab Clin North Am. 2020 Mar;49(1):179-202. doi: 10.1016/j.ecl.2019.10.008. Epub 2019 Dec 10.

Abstract

Treatment of type 1 diabetes with exogenous insulin often results in unpredictable daily glucose variability and hypoglycemia, which can be dangerous. Automated insulin delivery systems can improve glucose control while reducing burden for people with diabetes. One approach to improve treatment outcomes is to incorporate the counter-regulatory hormone glucagon into the automated delivery system to help prevent the hypoglycemia that can be induced by the slow pharmacodynamics of insulin action. This article explores the advantages and disadvantages of incorporating glucagon into dual-hormone automated hormone delivery systems.

Keywords: Dual-hormone artificial pancreas; Glucagon; Hypoglycemia; Intranasal glucagon; Minidose glucagon; Type 1 diabetes.

Publication types

  • Research Support, N.I.H., Extramural
  • Review

MeSH terms

  • Automation / instrumentation
  • Diabetes Mellitus, Type 1 / blood
  • Diabetes Mellitus, Type 1 / drug therapy*
  • Drug Therapy, Combination / instrumentation
  • Drug Therapy, Combination / methods
  • Glucagon / administration & dosage
  • Glucagon / physiology*
  • Glycemic Control / instrumentation
  • Glycemic Control / methods
  • Humans
  • Hypoglycemia / chemically induced
  • Hypoglycemia / prevention & control
  • Insulin / administration & dosage*
  • Insulin Infusion Systems*
  • Pancreas, Artificial

Substances

  • Insulin
  • Glucagon