Generated Narrative: Citation 267499

url: Citation 26681725 Intranasal Glucagon for Treatment of Insulin-Induced Hypoglycemia in Adults With Type 1 Diabetes: A Randomized Crossover Noninferiority Study.

identifier: FEvIR Object Identifier/267499, https://pubmed.ncbi.nlm.nih.gov/26681725, Uniform Resource Identifier (URI)/urn:oid:2.16.840.1.113883.4.642.40.44.15.35

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title: 26681725 Intranasal Glucagon for Treatment of Insulin-Induced Hypoglycemia in Adults With Type 1 Diabetes: A Randomized Crossover Noninferiority Study.

status: Active

date: 2024-11-21 14:09:14+0000

publisher: HL7 International / Clinical Decision Support

contact: HL7 International / Clinical Decision Support: http://www.hl7.org/Special/committees/dss

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approvalDate: 2016-07-26

lastReviewDate: 2022-03-30

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citedArtifact

identifier: https://pubmed.ncbi.nlm.nih.gov/26681725, https://www.ncbi.nlm.nih.gov/pmc//PMC4722945, https://doi.org/10.2337/dc15-1498, pii/dc15-1498

Titles

-	Type	Language	Text
*	Primary title	English	Intranasal Glucagon for Treatment of Insulin-Induced Hypoglycemia in Adults With Type 1 Diabetes: A Randomized Crossover Noninferiority Study.

Abstracts

-	Text	Copyright
*	OBJECTIVE: Treatment of severe hypoglycemia with loss of consciousness or seizure outside of the hospital setting is presently limited to intramuscular glucagon requiring reconstitution immediately prior to injection, a process prone to error or omission. A needle-free intranasal glucagon preparation was compared with intramuscular glucagon for treatment of insulin-induced hypoglycemia. <AbstractText Label="RESEARCH DESIGN AND METHODS" NlmCategory="METHODS">At eight clinical centers, a randomized crossover noninferiority trial was conducted involving 75 adults with type 1 diabetes (mean age, 33 ± 12 years; median diabetes duration, 18 years) to compare intranasal (3 mg) versus intramuscular (1 mg) glucagon for treatment of hypoglycemia induced by intravenous insulin. Success was defined as an increase in plasma glucose to ≥70 mg/dL or ≥20 mg/dL from the glucose nadir within 30 min after receiving glucagon. RESULTS: Mean plasma glucose at time of glucagon administration was 48 ± 8 and 49 ± 8 mg/dL at the intranasal and intramuscular visits, respectively. Success criteria were met at all but one intranasal visit and at all intramuscular visits (98.7% vs. 100%; difference 1.3%, upper end of 1-sided 97.5% CI 4.0%). Mean time to success was 16 min for intranasal and 13 min for intramuscular (P < 0.001). Head/facial discomfort was reported during 25% of intranasal and 9% of intramuscular dosing visits; nausea (with or without vomiting) occurred with 35% and 38% of visits, respectively. CONCLUSIONS: Intranasal glucagon was highly effective in treating insulin-induced hypoglycemia in adults with type 1 diabetes. Although the trial was conducted in a controlled setting, the results are applicable to real-world management of severe hypoglycemia, which occurs owing to excessive therapeutic insulin relative to the impaired or absent endogenous glucagon response.	© 2016 by the American Diabetes Association. Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered.

relatesTo

type: cites

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Diabetes Care. 2016 Oct;39(10):e192. doi: 10.2337/dc16-0955

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Diabetes Care. 2016 Oct;39(10):e193-4. doi: 10.2337/dci16-0025

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identifier: Electronic ISSN Type/1935-5548, ISOAbbreviation/Diabetes Care, ISSN Linking/0149-5992, Medline Title Abbreviation/Diabetes Care, NLM Unique ID/7805975

title: Diabetes care

publisherLocation: United States

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issue: 2

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contributor: Ruedy KJ

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affiliation: Jaeb Center for Health Research, Tampa, FL.

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contributor: Foster NC

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affiliation: Jaeb Center for Health Research, Tampa, FL t1dstats@jaeb.org.

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contributor: Piché CA

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affiliation: Locemia Solutions ULC, Montreal, QC, Canada.

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contributor: Dulude H

forenameInitials: H

affiliation: Locemia Solutions ULC, Montreal, QC, Canada.

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contributor: Sherr JL

forenameInitials: JL

affiliation: Yale School of Medicine, New Haven, CT.

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contributor: Tamborlane WV

forenameInitials: WV

affiliation: Yale School of Medicine, New Haven, CT.

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contributor: Bethin KE

forenameInitials: KE

affiliation: Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, The State University of New York, Buffalo, NY.

entry

contributor: DiMeglio LA

forenameInitials: LA

affiliation: Indiana University School of Medicine, Indianapolis, IN.

entry

contributor: Wadwa RP

forenameInitials: RP

affiliation: Barbara Davis Center for Childhood Diabetes, Aurora, CO.

entry

contributor: Ahmann AJ

forenameInitials: AJ

affiliation: Harold Schnitzer Diabetes Health Center, Oregon Health & Science University, Portland, OR.

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contributor: Haller MJ

forenameInitials: MJ

affiliation: University of Florida, Gainesville, FL.

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contributor: Nathan BM

forenameInitials: BM

affiliation: University of Minnesota, Minneapolis, MN.

entry

contributor: Marcovina SM

forenameInitials: SM

affiliation: Northwest Lipid Metabolism and Diabetes Research Laboratories, Seattle, WA.

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contributor: Rampakakis E

forenameInitials: E

affiliation: JSS Medical Research, St. Laurent, QC, Canada.

entry

contributor: Meng L

forenameInitials: L

affiliation: JSS Medical Research, St. Laurent, QC, Canada.

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contributor: Beck RW

forenameInitials: RW

affiliation: Jaeb Center for Health Research, Tampa, FL.

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contributor: T1D Exchange Intranasal Glucagon Investigators

Generated Narrative: Practitioner #contributor0

name: Michael R Rickels

Generated Narrative: Practitioner #contributor1

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name: Nicole C Foster

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artifact: Citation 26681725 Intranasal Glucagon for Treatment of Insulin-Induced Hypoglycemia in Adults With Type 1 Diabetes: A Randomized Crossover Noninferiority Study.

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