In Diabetes Emergencies, This Nasal Spray Might Work

Powdered glucagon nasal spray was nearly as effective as injection for type 1 diabetes patients

/ Author:  / Reviewed by: Beth Bolt, RPh

(RxWiki News) When a diabetes patient has severely low blood sugar, you've got to act fast. And an injection might not be the only viable option.

A nasal spray might work, too. A new study found that a powdered glucagon nasal spray was nearly as effective as the standard glucagon injection in rescue care for diabetes patients.

"Intranasal glucagon was highly effective in treating insulin-induced hypoglycemia in adults with type 1 diabetes," wrote first study author Michael R. Rickels, MD, an endocrinologist in Philadelphia, and colleagues. "Although the trial was conducted in a controlled setting, the results are applicable to real-world management of severe hypoglycemia ..."

Type 1 diabetes is a chronic disease in which the body makes little or no insulin, a hormone that regulates blood sugar. This can lead to high blood sugar. In the long-term, untreated type 1 diabetes can lead to kidney and heart disease, among other health problems.

Some patients might experience extremely low blood sugar after injecting insulin. When that happens, patients often receive glucagon to raise their blood sugar back to normal levels. The only glucagon approved by the US Food and Drug Administration (FDA) is powdered and must be mixed and processed to be injected.

A nasal spray could represent a more easily usable option, Dr. Rickels and team noted.

To test that theory, these researchers induced low blood sugar (hypoglycemia) twice in 75 type 1 diabetes patients. One time, the patients received the glucagon injections. Another time, they received the glucagon nasal spray.

The injection was effective 100 percent of the time. The nasal spray worked 98.7 percent of the time. The spray also took about three minutes longer than the injection to take effect. Rates of reported side effects were similar — except the nasal spray was tied to more reports of head and facial discomfort.

Despite some small differences between the nasal spray and injections, Dr. Rickels and team noted that the glucagon nasal spray could be an effective rescue treatment for type 1 diabetes patients with hypoglycemia.

The nasal spray is not currently FDA-approved.

This study was published in the journal Diabetes Care. Information on funding sources and conflicts of interest was not available at the time of publication.

Reviewed by: 
Review Date: 
December 25, 2015
Last Updated:
December 28, 2015