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Not only for caregivers: intranasal glucagon for severe hypoglycaemia in a simulation study

A Monzani1, S Savastio1, A Manzo1

  • 1Division of Paediatrics, Department of Health Sciences, University of Piemonte Orientale, via Solaroli 17, 28100, Novara, Italy.

Acta Diabetologica
|August 11, 2022
PubMed

Insights

Intranasal (IN) glucagon offers a highly effective and rapid treatment for severe hypoglycemia in children with type 1 diabetes. Training significantly improves administration success rates and speed for both IN and injectable glucagon.

Area of Science:

  • Pediatric Endocrinology
  • Emergency Medicine
  • Diabetes Management

Background:

  • Severe hypoglycemia is a critical complication in children with type 1 diabetes (T1DM).
  • Timely and effective treatment is crucial to prevent neurological damage.
  • Current treatment options include injectable glucagon and intravenous glucose, with varying administration challenges.

Purpose of the Study:

  • To compare the choices of pediatric and emergency medicine residents regarding therapeutic options for severe hypoglycemia in T1DM.
  • To evaluate the speed and success rate of glucagon administration (injectable vs. intranasal) in a simulated pediatric severe hypoglycemia scenario.
  • To assess the impact of training on the selection and administration of glucagon.

Main Methods:

  • A high-fidelity simulation study involving 51 pediatric and emergency medicine residents.
  • Residents were exposed to a severe hypoglycemia scenario in a T1DM child before and after training.
  • Training focused on the preparation and administration of both injectable and intranasal (IN) glucagon.
  • Data collected included therapeutic choices, time to drug delivery, and administration success rates.

Main Results:

  • Before training, injectable glucagon was chosen by 45.1%, intravenous glucose by 43.1%, and IN glucagon by 5.9%.
  • Post-training, IN glucagon use increased to 58.8%, with 100% successful administration.
  • Injectable glucagon administration success improved to 90.5% post-training.
  • Time to successful administration was significantly shorter for IN glucagon (23s) compared to injectable glucagon (38s).

Conclusions:

  • Intranasal glucagon is an effective and user-friendly option for treating severe hypoglycemia in children with T1DM.
  • Adequate training is essential to maximize the success and efficiency of IN glucagon administration.
  • The study highlights the potential of IN glucagon as a rapid and reliable alternative to traditional methods.
Abstract

Keywords:
AdolescentsChildrenHypoglycaemiaIntranasal glucagonSimulationType 1 diabetes

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