Dasiglucagon effectively reduces postprandial hypoglycemia after bariatric surgery

Denmark: A recent study in the journal Diabetes Care showed that dasiglucagon effectively reduced postprandial hypoglycemia in Roux-en-Y gastric bypass (RYGB)–operated patients suffering from post-bariatric hypoglycemia (PBH). Dasiglucagon is a novel stable glucagon analog in a liquid formulation.

Dasiglucagon is an antihypoglycemic agent indicated for treating severe hypoglycemia in pediatric and adult patients with diabetes aged 6 years and above. It works by stimulating glycogen breakdown and release of glucose from the liver by increasing the blood glucose concentration by activating hepatic glucagon receptors. Dasiglucagon comes in 0.6 mg/0.6 mL single-dose autoinjector and 0.6 mg/0.6 mL single-dose prefilled syringe. 

The study was conducted by Filip K. Knop, Copenhagen University Hospital – Herlev and Gentofte, Hellerup, Denmark, and colleagues with an aim to investigate the efficacy and safety of dasiglucagon, in Roux-en-Y gastric bypass–operated individuals suffering from postbariatric hypoglycemia in a randomized, double-blind, placebo-controlled, crossover trial. 

The study included 10 RYGB-operated participants with continuous glucose monitoring–verified PBH. They were randomly assigned to 3 trial days, each consisting of a 240-min standardized liquid mixed-meal test with the subcutaneous injection of placebo or 80 μg or 200 μg dasiglucagon. 

Treatment with both 80 and 200 µg dasiglucagon compared with placebo increased nadir plasma glucose (PG) (placebo: 3.0 ± 0.2 mmol/L [mean ± SEM]; 80 μg dasiglucagon: 3.9 ± 0.3 mmol/L; 200 μg dasiglucagon: 4.5 ± 0.2 mmol/L) and reduced time in hypoglycemia (PG <3.9 mmol/L) by 70.0 min.

To conclude, single-dose administration of dasiglucagon effectively mitigated postprandial hypoglycemia. 

"Our findings suggest that dasiglucagon may be a useful therapeutic agent for postbariatric postprandial hypoglycemia," the authors conclude. "There is a need for further studies assessing the side effects of dasiglucagon administration."

Reference:

Casper K. Nielsen, Caroline C. Øhrstrøm, Urd L. Kielgast, Dorte L. Hansen, Bolette Hartmann, Jens J. Holst, Asger Lund, Tina Vilsbøll, Filip K. Knop; Dasiglucagon Effectively Mitigates Postbariatric Postprandial Hypoglycemia: A Randomized, Double-Blind, Placebo-Controlled, Crossover Trial. Diabetes Care 2022; dc212252. https://doi.org/10.2337/dc21-2252