Glucagon orchestrates stress-induced hyperglycaemia
J B Harp1, G D Yancopoulos1, J Gromada1
1Regeneron Pharmaceuticals, Inc., Tarrytown, NY, USA.
Diabetes, Obesity & Metabolism
|March 31, 2016
Summary
Stress-induced hyperglycemia (SIH), common in hospitalized patients, involves hormonal imbalances and increases mortality risk. Glucagon plays a key role, suggesting new therapies targeting glucagon may improve glucose control.
Area of Science:
- Endocrinology
- Metabolic Disorders
- Critical Care Medicine
Background:
- Transient hyperglycemia, termed stress-induced hyperglycemia (SIH), is prevalent in hospitalized patients due to illness, injury, or surgery.
- SIH occurs frequently in individuals without prior diabetes history, presenting hormonal disturbances similar to diabetes mellitus.
- Elevated catecholamines and cortisol characterize SIH, differentiating it from uncomplicated diabetes mellitus.
Purpose of the Study:
- To review the critical role of glucagon in the pathophysiology of stress-induced hyperglycemia.
- To explore novel therapeutic strategies for managing SIH, focusing on agents that modulate glucagon signaling.
Main Methods:
- Literature review focusing on hormonal mechanisms in SIH.
- Analysis of existing and emerging therapeutic targets for glucose regulation in acute illness.
Main Results:
- SIH is associated with significantly higher morbidity and mortality rates compared to normoglycemic hospitalized patients.
- The risk is particularly elevated in patients without pre-existing diabetes.
- Glucagon excess is a key hormonal feature contributing to SIH.
Conclusions:
- Insulin remains the standard treatment for SIH, but limitations exist.
- Targeting glucagon, via glucagon receptor blockers or GLP-1 receptor agonists, presents a promising avenue for improved SIH management and reduced glucose variability.
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