Glucagon treatment in type 1 diabetes -with focus on restoring plasma glucose during mild hypoglycemia


Type 1 diabetes is a chronic disease caused by an autoimmune destruction of the insulin-producing cells in the pancreas, leading to a condition with insulin deficiency and elevated blood glucose levels. Individuals with type 1 diabetes are therefore recommended to frequently inject insulin subcutaneously to keep near-normal blood glucose levels, preventing the progression and onset of diabetes-related complications, i.e. kidney failure, blindness, amputation, stroke and heart attack. Unfortunately, the intensified insulin therapy is associated with risk of hypoglycemia- impeding individuals from reaching recommended treatment goals. In this PhD thesis, we hypothesized that low-dose glucagon may complement existing insulin therapy in improving glucose control by treating and preventing mild hypoglycemia.
 The aim was to determine whether low-dose glucagon could treat insulin-induced mild hypoglycemia sufficiently, and to investigate conditions that might impair the efficacy of glucagon. We showed that the glucose response to low-dose glucagon was dose-dependent but was impaired during high blood levels of insulin, after one week of low carbohydrate diet and perhaps 8-9 hours after ethanol intake. These findings are clinically relevant when blood glucose levels are controlled through insulin and glucagon delivery.