In patients with insulin-treated diabetes, the consequences of a hypoglycaemic episode depend on its severity and duration. Severe hypoglycaemia sometimes causes loss of consciousness or even death.

Glucagon is a hormone that raises blood glucose levels by releasing the glucose stored in the liver in the form of glycogen into the bloodstream. It is a drug of choice for hypoglycaemia in patients with insulin-treated diabetes who have lost consciousness and can no longer take carbohydrates orally. Normal consciousness is generally restored within about 15 minutes after administering glucagon, obviating the need for medical intervention or hospitalisation. Glucagon is available in France as an injectable solution that requires reconstitution before use and, since late 2020, as a powder for administration as a dry nasal spray.

In two randomised comparative trials in adults with insulin-treated diabetes, nasal glucagon had similar efficacy to intramuscular glucagon, including in patients with nasal congestion (due to a cold for example).

Glucagon dry nasal spray (Baqsimi°) is supplied in ready-to-use single-dose spray devices that are stored at room temperature, facilitating the emergency management of severe hypoglycaemia, especially when the person present is not comfortable giving injections.

©Prescrire 1 December 2021

Source: "Nasal glucagon (Baqsimi°) and hypoglycaemia with loss of consciousness" Prescrire International 2021; 30 (232): 289. Subscribers only.

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