In the Journals

Autoinjector bests emergency kit as glucagon dispenser during severe hypoglycemic events

An autoinjector proved simpler to use and more efficient at administering glucagon during simulated hypoglycemic episodes compared with a glucagon emergency kit, according to findings published in Diabetes Technology & Therapeutics.

Virginia Valentine

“The optimal scenario during a diabetes emergency is the delivery of glucagon in a ready-to-use format that is user-centric, intuitive, reliable and enables complete dose delivery,” Virginia Valentine, APRN, BC-ADM, CDE, FAADE, a diabetes specialist at the Clinica La Esperanza in Albuquerque, New Mexico, and colleagues wrote. “Thus, a need exists for an improved device for hypoglycemic rescue that provides ease-of-use for all potential users as well as reliable delivery of a complete dose of glucagon.”

Valentine and colleagues recruited 16 adults for two hypoglycemia rescue simulation exercises in which participants used a glycemic emergency kit during one exercise and the glucagon autoinjector (Gvoke HypoPen, Xeris Pharmaceuticals) during the other. The total cohort was made up of participants who had used a glycemic emergency kit before (n = 8; mean age, 35.5 years; four women) and those who had not (n = 8; mean age, 37.4 years; five women).

Each simulated situation required the participants to use the injector or kit with a mannequin, with the researchers observing how many participants successfully completed each procedure and how long each took to complete. A successful injection occurred more frequently with the autoinjector compared with the kit (88% vs. 31%; P < .05), according to the researchers. The autoinjector also took less time to be used, on average, compared with the kit (47.9 seconds vs. 109 seconds; P < .05), and the researchers further noted that the autoinjector had a lower step error rate compared with the kit (3.6% vs. 20.1%; P < .05).

In a validation analysis using the autoinjector alone with 75 participants (aged 12-69 years) of varying degrees of familiarity and training with the device, glucagon was administered successfully by 98.7% of the cohort, the researchers wrote, and previous training and age did not seem to affect the ability to complete the process.

“This usability advantage over existing [glucagon emergency kits] will hopefully inspire more confidence in caregivers of patients with diabetes and translate to more widespread use of glucagon in treating severe hypoglycemia in the home or ambulatory setting,” the researchers wrote. “The [glucagon autoinjector] could not only help save lives, but also limit emergency department visits and thus lower the burden of severe hypoglycemia on the health care system as a whole.” – by Phil Neuffer

Disclosures: Valentine reports she has served as a consultant or on the advisory board for Abbott Diabetes Care, Adocia, AstraZeneca, Capillary Biomedical, Cequr, Intarcia Therapeutics, Janssen Pharmaceuticals, Lexicon Pharmaceuticals, Eli Lilly, Novo Nordisk and Sanofi. Please see the study for all other authors’ relevant financial disclosures.

An autoinjector proved simpler to use and more efficient at administering glucagon during simulated hypoglycemic episodes compared with a glucagon emergency kit, according to findings published in Diabetes Technology & Therapeutics.

Virginia Valentine

“The optimal scenario during a diabetes emergency is the delivery of glucagon in a ready-to-use format that is user-centric, intuitive, reliable and enables complete dose delivery,” Virginia Valentine, APRN, BC-ADM, CDE, FAADE, a diabetes specialist at the Clinica La Esperanza in Albuquerque, New Mexico, and colleagues wrote. “Thus, a need exists for an improved device for hypoglycemic rescue that provides ease-of-use for all potential users as well as reliable delivery of a complete dose of glucagon.”

Valentine and colleagues recruited 16 adults for two hypoglycemia rescue simulation exercises in which participants used a glycemic emergency kit during one exercise and the glucagon autoinjector (Gvoke HypoPen, Xeris Pharmaceuticals) during the other. The total cohort was made up of participants who had used a glycemic emergency kit before (n = 8; mean age, 35.5 years; four women) and those who had not (n = 8; mean age, 37.4 years; five women).

Each simulated situation required the participants to use the injector or kit with a mannequin, with the researchers observing how many participants successfully completed each procedure and how long each took to complete. A successful injection occurred more frequently with the autoinjector compared with the kit (88% vs. 31%; P < .05), according to the researchers. The autoinjector also took less time to be used, on average, compared with the kit (47.9 seconds vs. 109 seconds; P < .05), and the researchers further noted that the autoinjector had a lower step error rate compared with the kit (3.6% vs. 20.1%; P < .05).

In a validation analysis using the autoinjector alone with 75 participants (aged 12-69 years) of varying degrees of familiarity and training with the device, glucagon was administered successfully by 98.7% of the cohort, the researchers wrote, and previous training and age did not seem to affect the ability to complete the process.

“This usability advantage over existing [glucagon emergency kits] will hopefully inspire more confidence in caregivers of patients with diabetes and translate to more widespread use of glucagon in treating severe hypoglycemia in the home or ambulatory setting,” the researchers wrote. “The [glucagon autoinjector] could not only help save lives, but also limit emergency department visits and thus lower the burden of severe hypoglycemia on the health care system as a whole.” – by Phil Neuffer

Disclosures: Valentine reports she has served as a consultant or on the advisory board for Abbott Diabetes Care, Adocia, AstraZeneca, Capillary Biomedical, Cequr, Intarcia Therapeutics, Janssen Pharmaceuticals, Lexicon Pharmaceuticals, Eli Lilly, Novo Nordisk and Sanofi. Please see the study for all other authors’ relevant financial disclosures.