Glucagon implant

[Lisa65]

Sounds good in principle, but if it was linked to CGM what's to stop it firing off if you got a compression low or a failed sensor giving false low readings.

Implantable device could save diabetes patients from dangerously low blood sugar

MIT engineers developed an implantable reservoir that can remain under the skin and be triggered to release glucagon when people with diabetes are in danger of becoming hypoglycemic.

news.mit.edu

 

[SimonP]

I assume for a useful system whatever device was in control of making the decision would make enough noise/notifications that you'd notice and cancel it if not needed, or not if needed.

A bit like the emergency services/emergency contacts summoning systems that track and notify in case of falls on smart watches and bike computers - you certainly can't miss the fact it's going to do something soon!

 

[Inka]

Sounds good in principle, but if it was linked to CGM what's to stop it firing off if you got a compression low or a failed sensor giving false low readings.

Implantable device could save diabetes patients from dangerously low blood sugar

MIT engineers developed an implantable reservoir that can remain under the skin and be triggered to release glucagon when people with diabetes are in danger of becoming hypoglycemic.

news.mit.edu

Glucagon makes me vomit dreadfully (and quite a few other people too). It’s a pity they can’t use glucose.

 

[rebrascora]

My diabetes management would have to be pretty dire for me to be interested in this.

I know there are people who have lost hypo awareness and have very serious hypos who might benefit from this but I think they are a small minority and with the widespread use of CGM now, there is a real opportunity for people to prevent themselves getting into that sort of situation in the future, so I do wonder whether the application is limited.... perhaps more with Type 3cs particularly those who have lost alpha cell function. At the end of the day for most of us, our own body is capable of triggering a release of glucagon although with increased exposure to hypos, this diminishes.

I know this is likely a second arm to insulin pumping and HCL and making it more comprehensive, but I am not sure a fully automated system is something I would want for myself.

 

[everydayupsanddowns]

Saw this earlier and thought it was really interesting.

Hope it provides a lifeline for those with no hypo warning signs and multiple Severe Hypoglycaemia (needing external help) per year.

 

[Proud to be erratic]

Sounds good in principle, but if it was linked to CGM what's to stop it firing off if you got a compression low or a failed sensor giving false low readings.

Implantable device could save diabetes patients from dangerously low blood sugar

MIT engineers developed an implantable reservoir that can remain under the skin and be triggered to release glucagon when people with diabetes are in danger of becoming hypoglycemic.

news.mit.edu

It's still very early days with this research and development. There is plenty of time to refine the circumstances when the glucagon might be actually needed. Just the process of getting approvals to formally market this product should "tease out" basic "what if ..... " questions

 

[Bruce Stephens]

It’s a pity they can’t use glucose.

The problem there is volume. To get 5g of glucose you need 5g of glucose.

 

[SimonP]

My diabetes management would have to be pretty dire for me to be interested in this.

Agreed, though I could see it as a last resort backup sort of thing.

At the end of the day for most of us, our own body is capable of triggering a release of glucagon although with increased exposure to hypos, this diminishes.

I've certainly read that the liver is less interested in producing glucagon in T1 (etc) diabetics as time goes on, I didn't see )(in whatever I read) that this was specifically due to hypo exposure - one assumes the same effect would be true for those who are often short of food (like most humans over history) and I assumed it was a side-effect of the general endocrine disruption, I may well be wrong though, would be interesting to know what the current working theory is on this.

With that said, I'm coming up on 40y and it still appears to work well enough, fingers crossed! 🙂

 

[trophywench]

Just carries on carrying on after 40 and 50 years, Simon, same as it did after 10 20 and 30. Trouble is, other bits of 'you' don't work as well though.

 

[trophywench]

Defo a Glucagon vomiter here. No Ta.

 

[SimonP]

I think I've only been injected once, perhaps twice, I definitely felt very nauseous afterwards - though somewhat hard to differentiate between that and the effects of alcohol!

Probably the glucagon mind you!

I've also read that this effect is due to the very large dosage that is administered, and that if one could receive a smaller dosage (á la dual hormone pumps), the nausea wouldn't happen.

 

[trophywench]

I think I've only been injected once, perhaps twice, I definitely felt very nauseous afterwards - though somewhat hard to differentiate between that and the effects of alcohol!

Probably the glucagon mind you!

I've also read that this effect is due to the very large dosage that is administered, and that if one could receive a smaller dosage (á la dual hormone pumps), the nausea wouldn't happen.

That is of course a possibility @SimonP - but none of us has ever been in a position to experiment with doses.

Makes one wonder - overdosing insulin and accidentally killing oneself must presumably be less deadly that over/underdosing glucagon, since we're welcome to do the first but utterly banned from the second.

 

[SimonP]

Are we banned or in any other way unable to do this though? I must admit I don't even have a glucagon kit any more, perhaps I should order one, but assuming I did, I could draw up as much as I wanted and experiment (or have the kits changed since I last threw one out - containing a vial of sterile water (saline?) and a vial of powdered glucagon all in a nice orange case)?

Probably easier to eat something with glucose in it though!

 

[Lucyr]

Makes one wonder - overdosing insulin and accidentally killing oneself must presumably be less deadly that over/underdosing glucagon, since we're welcome to do the first but utterly banned from the second.

I don’t understand what you mean? Who has banned me from over/underdosing glucagon? How can I possibly be banned from both over and under dosing it?

 

[trophywench]

The Glucagon jab kits issued for home use are an exactly measured amount of both the powder and the ?distilled water which have to be mixed together immediately prior to use, before the syringe needle is plunged into the recipient. Needs to be a very fleshy part with no internal structures particularly near, hence with myself, and my husband doing the deed, would usually be one of my bum cheeks. A while after having the jab I'd start to regain proper consciousness again but as soon as I started to move I'd projectile vomit over whatever happened to be in it's path.

I suppose the administrator could only inject 'some' of the liquid, but that's not in the instructions, so why would they? - and you can't keep it 'for another time' once it's mixed, a single use syringe and have to rotate the syringe well anyway to keep the powder suspended - presumably if you stop doing that, it separates again. (Dunno, never seen it being done since I've always been non compos mentis)

 

[martindt1606]

If they were willing to fund an all expenses trip I'd volunteer to try this out. With no pancreas and liver metastasis this would be a great tool to help manage the impact of brittle diabetes. However not going to hold my breath waiting for continued development and progression to NICE approval.....................

 

[Lucyr]

The Glucagon jab kits issued for home use are an exactly measured amount of both the powder and the ?distilled water which have to be mixed together immediately prior to use, before the syringe needle is plunged into the recipient.

Surely if I wanted to underdose I could just not take any glucagon and if I wanted to overdose I could take two

 

[Sally71]

You only need glucagon if you are completely unresponsive though, you’d need someone else to administer it for you anyway, if you’re capable of thinking “oh I’m low, I need to do something” then it’s better to just eat some glucose!

I always have problems every time I try to order a glucagon kit for my daughter though. All other prescription items get automatically sent electronically to the local chemist for me to pick up a couple of days later. Glucagon does not, it gets stopped by the doctor and I have to go into the surgery to ask for a paper prescription. Every time I ask why this is, I’m always told that it’s because it’s a controlled drug. I mentioned this to the pharmacist once and she said that’s utterly ridiculous, there are no such restrictions on insulin and that’s far more dangerous if it falls into the wrong hands or if you accidentally get the dose wrong! Something peculiar going on there…. I’m seriously thinking of not ordering another one when the current one goes out of date, we’ve never needed it and with pumps and CGMs it’s highly unlikely that we ever will need one.

 

[trophywench]

Well these days it either goes out of date without being used so has to be opened and the liquid inside the syringe expelled, then get the ruddy stupid syringe into my far to small for such a thing Sharps box, since the pharmacy will not dispose of such things. Hence I never bothered requesting another some years ago.

 

[everydayupsanddowns]

Interestingly my old kit went out of date and the new one is a premixed pen, wrapped in an inflated foil wrapper which must not be stored in the fridge.

Was a bit of a surprise. And weirdly I don’t actually know where to put it, where it’ll be immediately obvious if ever needed. Bathroom cabinet maybe??