At the end of September 2019, Health Canada approved the BAQSIMI™ nasal glucagon, a new treatment for severe hypoglycemia. The highly anticipated drug is now available in Quebec pharmacies.
With hypoglycemia being insulin’s main adverse effect, anyone living with type 1 diabetes is at risk. This risk affects their everyday life and their ability to achieve proper blood sugar management.
People who experience severe hypoglycemia can’t treat it themselves and can even lose consciousness. Up until now, the only way for someone to help treat severe hypoglycemia was to inject glucagon with a syringe.
The limits of injectable glucagon
A study that was presented at the 2015 EASD Meeting sought to compare the ease of use of both treatments and simulated an emergency situation in which caregivers and trained healthcare workers had to treat severe hypoglycemia with either injectable glucagon or nasal glucagon.
The results showed that:
- Only 12.5% of healthcare workers administered injectable glucagon adequately.
- As many as 94% of healthcare workers and caregivers administered nasal glucagon adequately.
- Administering nasal glucagon was seven times quicker for healthcare workers (16 seconds vs 1 min 53 s) and 5 times quicker for caregivers (26 seconds vs 2 min 24 s).
These results are probably due to the fact that injectable glucagon is not ready for use; it needs to be reconstituted and several steps need to be followed before it can be injected. This can explain why it’s not always used adequately.
Nasal glucagon, on the other hand, is ready to use and is administered in the nose, so it’s much easier to use.
Other studies have shown that nasal glucagon is just as effective as injectable glucagon for bringing blood sugar levels back up in adults and children, and even in the case of a cold since the powder doesn’t need to be inhaled.
About nasal glucagon
Who is it for?
Nasal glucagon can be used to treat severe hypoglycemia in children over four years old and adults who use insulin.
Nasal glucagon is ready to use, which means it doesn’t need any reconstitution. One tube contains a 3 mg single-use glucagon powder dose (one dose for all). It’s administered in just three steps:
Nasal glucagon has a shelf life of two years and has to be kept at room temperature. It’s preferable to keep it away from areas that are subject to extreme temperatures, such as the car.
It’s important to keep the tube closed and sealed; an open tube could expose the product to humidity, which could reduce its effectiveness.
How about the cost?
The manufacturer has announced a selling price of $131.60. A request to have it covered under the public plan was submitted to the RAMQ (Régie de l’assurance maladie du Québec), but the final decision is still unknown.
Nasal glucagon offers a simpler and safer alternative to injectable glucagon to treat severe hypoglycemia. It should help the relatives or loved ones of type 1 diabetes patients to feel better equipped and more comfortable should they need to intervene during a severe hypoglycemia episode.
Reducing the severity and frequency of hypoglycemia episodes is one of the main goals of the BETTER project.
If you’re living with type 1 diabetes, you can participate and sign up to the registry.
- Yale, J.F., Dulude, H., Egeth, M., et al. (2017). Faster use and fewer failures with needle-free nasal glucagon versus injectable glucagon in severe hypoglycemia rescue: A simulation study. Diabetes Technol Ther 2017;19(7):423–432.