Xzantid Exantide.. Alert pancreatic to Faraz insulin and reduce the level of the hormone glucagon in the blood

Glucagon: why, when and how to use it with type 1 diabetes?

What is glucagon?

Glucagon is a hormone secreted by the alpha (α) cells of the islets of Langerhans in the pancreas, a gland in the abdomen involved in digestion and the production of hormones released into the blood1. The islets also include beta cells that make insulin.

Glucagon and type 1 diabetes: general

The absence of insulin in people with unbalanced or insufficiently treated type 1 diabetes is accompanied by hyper secretion of glucagon2 (which will then be corrected with glycemic normalization).

After the meal, people with diabetes experience an increase in glucagon (hyperglucagonemia), due to a decrease in the (retro)control of beta cells on the function of alpha5 cells.

However, over time, a defect in the production of glucagon will set in, all the more marked if the diabetes is old (progressive damage to the α cells of the islets of Langerhans). This secondary alteration in alpha cell function explained the decrease in the hyperglycemic response over time, in the event of hypoglycemia.

What are the main functions of glucagon in a person without type 1 diabetes?

A healthy pancreas secretes both insulin (beta β cells) and glucagon (alpha α cells) to maintain normal blood sugar levels. In a person without diabetes, glucagon is secreted to bring sugar levels back to normal when blood sugar is too low.

It is a hyperglycemic substance. It is the hormone of the need for energy, especially of the muscles under conditions like fasting and physical exercise. Its properties are opposite to those of insulin, which is hypoglycemic (lowering blood sugar levels). There is a balance between these two hormones, insulin and glucagon, to keep blood sugar levels within normal ranges.

The main action of glucagon

  The body stores glucose in a reserve form, glycogen, in large quantities in the liver. If necessary (fasting, muscular exercise, etc.), glucagon will allow the rapid destocking of glucose to meet the body's needs.

However, liver reserves are limited. When the body's energy needs persist and the liver's capacities are tested, the body then calls on another reserve: the fats (or lipids), required, under the influence in particular of glucagon (and the deficiency into insulin), could be transformed into ketone bodies3. The most common of these ketone bodies, ß-hydroxybutyrate, synthesized in the liver, passes into the blood and can then be used as an alternative fuel to glucose, in peripheral tissues.

What is the origin of glucagon secretion?

The main stimulant of glucagon secretion is the lowering of blood sugar4. Stress, through activation of the autonomic nervous system, protein ingestion5, and certain fatty acids can also promote glucagon secretion.

Can I use glucagon with type 1 diabetes? If so, when to use it?

Glucagon is the treatment for severe hypoglycemia. We speak of severe hypoglycemia when the person suffering from diabetes needs the help of a third party to take their treatment.

If the person cannot resugar orally (fruit juice, sugar, etc.) and in particular if they are unconscious, glucagon can then be administered subcutaneously or intramuscularly by a third party. After injection, it will cause a rise in blood sugar levels, within 5-15 minutes, and for about 10-40 minutes. Glucagon is available in pharmacies in the form of an injectable kit6. Glucagon also exists in the form of a nasal powder to diffuse directly into the nostril of the person concerned7.

With advances in technology, are other uses of glucagon for diabetes possible?

Technological advancements have the potential to improve the lives of people living with diabetes by reducing the risk of hypoglycemia, promoting overall blood sugar control and improving their quality of life.

A bi-hormonal solution to insulin and glucagon for diabetes: towards a replacement of the single hormone system?

Single-hormone (insulin only) and dual-hormone (insulin and glucagon) automated insulin delivery systems (which fall under the scientific category of "artificial pancreas") have been developed for people living with diabetes. , based on the connection of one or two insulin pump(s) to continuous glucose monitoring (CGM) and to a control algorithm (hosted in a dedicated device or directly in the pump).

For bi-hormonal solutions (insulin + glucagon), insulin