Major Hypoglycemia News From Paris Diabetes Conference

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T1D Exchange Severe hypoglycemia (very low blood sugar) is the dreaded fear of most people with diabetes. It can kill you.

A few weeks ago at the Advanced Technologies & Treatments for Diabetes (ATTD) conference in Paris, the T1D Exchange announced two findings that may:

  1. Prompt legislation to help older people with Type 1 diabetes prevent severe hypoglycemia
  2. Herald a new, simpler approach to glucagon “rescue” treatment for severe hypoglycemia — a needle-free, nasally-delivered glucagon

For the first time since glucagon became available more than 50 years ago, we may have an easy means to “save” a person with diabetes experiencing severe low blood sugar — the consequences of which include seizures, coma and death.

Over age 60, most at risk population for severe hypoglycemia
This data was first noticed through the T1D Exchange’s Registry of over 26,000 people with Type 1 diabetes: Twenty one percent (section 68) of people in the Registry over the age of 65 experienced a seizure or loss of consciousness due to hypoglycemia over the past year.

Surprisingly, a commonly cited risk factor for hypoglycemia, trying to maintain tight blood sugar control, was not the cause. A follow-up analysis comparing the 21 percent to study participants who had not had a severe low in the previous year, showed that they spent more time each day in the hypoglycemic range and their blood sugar levels fluctuated more, which can lead to being less aware of low blood sugar. This, despite the fact that they checked their blood sugar frequently (six times per day).

Irl Hirsch, M.D., professor of medicine and diabetes treatment and teaching chair at the University of Washington School of Medicine, said the problem is aggravated by Medicare patients often not being able to get much needed test strips and continuous glucose monitoring devices. The hope is that these findings will urge Medicare to make life-saving equipment more available to seniors.

Trial Results For Needle-Free Glucagon 
Lead investigator, Michael Rickels, M.D., associate professor of medicine at the University of Pennsylvania Perelman School of Medicine, shared data that the newly trialed glucagon shows comparable efficacy to current injected glucagon.

Rickels also cited the trialed glucagon’s delivery system — a puff in the nose similar to a nasal spray — as potentially life-changing. No longer will loved ones and caregivers need to fumble mixing glucagon ingredients or have the wits and capability to inject someone while they’re downright panicked.

Remarkably, this new glucagon is being developed not by a giant pharmaceutical company but by a small group of passionate individuals, many of whom are personally touched by Type 1 diabetes. Their company, Locemia Solutions, was created specifically to advance the awareness, education, prevention and treatment of hypoglycemia.

Co-creator and chairman, Robert Oringer, has two sons with Type 1 diabetes. Oringer told me, “I need a world where everyone can help anyone deal with severe low blood sugar really easily.”

Dr. Claude Piché, the company’s co-creator and CEO, shared with me that information supporting the idea of a needle-free nasal glucagon has existed since 1983. Yet no company took on the risk of developing it, until now.

Piché credits collaboration with the T1D Exchange along with its sharing model, and the support of the Leona M. and Harry B. Helmsley Charitable Trust, as integral to helping develop a simpler approach to hypoglycemia rescue. The company is conducting additional clinical trials and working closely with regulatory agencies to bring the product to market as soon as possible.

For me, living with Type 1 diabetes and being 61 years old, these findings are exciting. They hold the promise of greater safety and ease — for the millions of people with diabetes who use insulin and those who love them — to simply get through the day and live our lives.

Note: The T1D Exchange is a non-profit organization with a Registry of over 26,000people with Type 1 diabetes and a diverse and active social media community The T1D Exchange partners with more than 75 clinics across the country. Its unique collaborative model shares diabetes research, treatments, education and patient information and insights across diabetes stakeholders — patients, clinicians, scientists and industry — to accelerate better and faster therapies for Type 1 diabetes.

Originally published in The Huffington Post.

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