What is glucagon?

Glucagon is a hormone that promotes the breakdown of glycogen to glucose, making it useful in raising blood glucose levels during a hypoglycaemic episode.

Types of glucagon

Traditional glucagon kits1
FDA Approval
1988 with no age limitations
Administration & Details

  • Intramuscular or subcutaneous injection

Recommended Dosage

  • 1 mg for adults and children weighing >25kg or over 6 years old
  • 0.5 mg for children <25kg or under 6 years old
Nasal glucagon1
FDA Approval
2019
Administration & Details

  • A dry nasal spray requiring no reconstitution or priming
  • Dispensed using a single-dose dispenser

Recommended Dosage

  • A fixed dosage of 3 mg for severe hypoglycaemia treatment
Liquid-stable glucagon1
FDA Approval
2019 for paediatric and adult patients
Administration & Details

  • Prefilled syringe
  • Uses a native human glucagon protein that is dissolved in dimethyl sulfoxide (DMSO)

Recommended Dosage

  • 0.5 mg/0.1 mL for individuals less than 45 kg
  • 1 mg/0.2mL for individuals over 45 kg
Subcutaneous dasiglucagon2
FDA Approval
2021
Administration & Details

  • Glucagon analogue provided in an aqueous formulation
  • Dasiglucagon has similar receptor affinity and potency to native glucagon

Recommended Dosage

  • In T1D patients, dasiglucagon reverted hypoglycaemia at doses from 0.1 – 1.0 mg
Glucagon Type FDA Approval Administration & Details Recommended Dosage
Traditional glucagon kits1 1988 with no age limitations
  • Intramuscular or subcutaneous injection
  • 1 mg for adults and children weighing >25kg or over 6 years old
  • 0.5 mg for children <25kg or under 6 years old
Nasal glucagon1 2019
  • A dry nasal spray requiring no reconstitution or priming
  • Dispensed using a single-dose dispenser
  • A fixed dosage of 3 mg for severe hypoglycaemia treatment
Liquid-stable glucagon1 2019 for paediatric and adult patients
  • Prefilled syringe
  • Uses a native human glucagon protein that is dissolved in dimethyl sulfoxide (DMSO)
  • 0.5 mg/0.1 mL for individuals less than 45 kg
  • 1 mg/0.2mL for individuals over 45 kg
Subcutaneous dasiglucagon2 2021
  • Glucagon analogue provided in an aqueous formulation
  • Dasiglucagon has similar receptor affinity and potency to native glucagon
  • In T1D patients, dasiglucagon reverted hypoglycaemia at doses from 0.1 – 1.0 mg
diagram: types-of-glucagon

Mechanism of glucagon action, from La Sala & Pontiroli. 2021.2

Glucagon formulations undergoing clinical trials

Biochaperone glucagon3

  • Recombinant human glucagon
  • Prevents glucagon from degrading by adding compounds that form stable complexes with glucagon

Glucagon limitations

While useful, there are significant limitations to glucagon formulations. Glucagon formulations expire and are complicated to reconstitute. However, they are still used in many countries that don’t have access to nasal or pre-filled stable products.

References

  • 1
    Sherman JJ, Lariccia JL. Glucagon Therapy: A Comparison of Current and Novel TreatmentsDiabetes Spectr. 2020;33:347–351.
  • 2
    La Sala L & Pontiroli AE. New Fast Acting Glucagon for Recovery from Hypoglycemia, a Life-Threatening Situation: Nasal Powder and Injected Stable Solutions. 2021;22:10643.
  • 3
    Beato-Vibora PI & Arroyo-Diez FJ. New uses and formulations of glucagon for hypoglycaemia. Drugs Context. 2019;8:212599.