Evaluating dasiglucagon as a treatment option for hypoglycemia in diabetes

ABSTRACT

Introduction

Hypoglycemia in diabetes is a common and unresolved complication during diabetes therapy, even life-threatening. Effective and convenient treatment for rescuing severe diabetic hypoglycemia and maintaining euglycemia is in high demand to reduce hypoglycemia-related morbidity and mortality. Dasiglucagon is a novel glucagon analog for diabetic hypoglycemia therapy.

Areas covered

This review summarizes the reported studies associated with the pharmacokinetics, pharmacodynamics, safety, and tolerability characteristics, as well as clinical application of dasiglucagon for managing diabetic hypoglycemia.

Expert opinion

Dasiglucagon has demonstrated established solubility and stability in an aqueous formulation. Pharmacokinetics studies have shown dasiglucagon to exhibit higher absorption and a longer plasma elimination half-life than traditional reconstituted glucagon. Pharmacodynamic studies have shown that a full dose of 0.6 mg dasiglucagon could efficiently raise blood glucose level (BGL) by ≥20 mg/dL (9–10 min) from baseline following insulin-induced severe hypoglycemia in patients with type 1 diabetes, as well as rapidly increase BGL with small doses under euglycaemic and hypoglycemic conditions. Dasiglucagon is safe and well tolerated with the main adverse effects being nausea and vomiting. Collectively, dasiglucagon may be a promising candidate for severe diabetic hypoglycemic rescue and a continuous glycemic control in diabetic patients.

KEYWORDS:

• Dasiglucagon
• hypoglycemia
• glucagon analog
• diabetic hypoglycemia rescue

Article highlights

• Diabetic hypoglycemia is a common concern for diabetic patients receiving sulfonylurea or glinides treatment, while especially for insulin-dependent patients.

• Dasiglucagon, a novel peptide analog of human glucagon, effectively rescues insulin-induced severe hypoglycemia in patients with type 1 diabetes, as well as rapidly increase blood glucose level with small doses under euglycaemic and hypoglycaemic conditions.

• Dasiglucagon is safe and well tolerated with the main adverse effects of nausea and vomiting.

Box 1. Drug Summary Box.

Declaration of Interest

The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Reviewer Disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Additional information

Funding

This study was supported by the National Natural Science Foundation of China [81801832], the Postdoctoral Science Foundation of China [2019T120491, 2019M625046], the Natural Science Foundation of Ningbo [2018A610273] and the Scientific Research Fund of Zhejiang Provincial Education Department [Y201840521].