At risk and unprepared for severe hypoglycemia

While the American Diabetes Association recommends rescue treatments be available for those at risk for severe hypoglycemia, the rescue treatments that patients do have on hand are sometimes left to expire^1,2

Patient responses to status of glucagon in the home in 2015²*

25.7^%

EXPIRED

33.2^%

DON'T KNOW

*Two hundred eighteen patients were surveyed in 2013, and 200 patients were surveyed in 2015. There were 132 patients who participated in both surveys, which included patients with type 1 diabetes who were using an insulin pump or multiple daily injections and patients with type 2 diabetes who were using an insulin pump. Patients were identified and screened each day prior to their clinic appointments and were asked questions about their glucagon use. 67.4% of the patients surveyed in 2013 and 57% of the patients surveyed in 2015 used insulin pump therapy to administer insulin. The remaining patients used multiple daily injections to administer insulin.²

Glucagon rescue treatment has been reported to be underutilized²

Patients and caregivers may keep glucose levels high to reduce the risk of severe hypoglycemia³

Preparing patients for severe hypoglycemia means making sure those around them are ready to help¹

Caregivers, such as family members or school personnel, should know where the patient’s rescue medication is located, as well as when and how to administer it¹

Discover a rescue treatment option that helps your patients and their caregivers be prepared for the treatment of severe hypoglycemia⁴

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Indication and Usage for ZEGALOGUE^® (dasiglucagon) injection 0.6 mg/0.6 mL

ZEGALOGUE^® (dasiglucagon) injection is indicated for the treatment of severe hypoglycemia in pediatric and adult patients with diabetes aged 6 years and above.

Important Safety Information

Contraindications

ZEGALOGUE^® is contraindicated in patients with pheochromocytoma because of the risk of substantial increase in blood pressure and in patients with insulinoma because of the risk of hypoglycemia.

Warnings and Precautions

ZEGALOGUE^® is contraindicated in patients with pheochromocytoma because glucagon products may stimulate the release of catecholamines from the tumor. If the patient develops a substantial increase in blood pressure and a previously undiagnosed pheochromocytoma is suspected, 5 to 10 mg of phentolamine mesylate, administered intravenously, has been shown to be effective in lowering blood pressure.
In patients with insulinoma, administration of glucagon products may produce an initial increase in blood glucose; however, ZEGALOGUE^® administration may directly or indirectly (through an initial rise in blood glucose) stimulate exaggerated insulin release from an insulinoma and cause hypoglycemia. ZEGALOGUE^® is contraindicated in patients with insulinoma. If a patient develops symptoms of hypoglycemia after a dose of ZEGALOGUE^®, give glucose orally or intravenously.
Allergic reactions have been reported with glucagon products; these include generalized rash, and in some cases anaphylactic shock with breathing difficulties and hypotension. Advise patients to seek immediate medical attention if they experience any symptoms of serious hypersensitivity reactions.
ZEGALOGUE^® is effective in treating hypoglycemia only if sufficient hepatic glycogen is present. Patients in states of starvation, with adrenal insufficiency or chronic hypoglycemia may not have adequate levels of hepatic glycogen for ZEGALOGUE^® administration to be effective. Patients with these conditions should be treated with glucose.

Adverse Reactions

The most common adverse reactions (≥2%) associated with ZEGALOGUE^® in adults were nausea, vomiting, headache, diarrhea and injection site pain; in pediatrics: nausea, vomiting, headache and injection site pain.

Drug Interactions

Patients taking beta-blockers may have a transient increase in pulse and blood pressure when given ZEGALOGUE^®. In patients taking indomethacin, ZEGALOGUE^® may lose its ability to raise blood glucose or may produce hypoglycemia. ZEGALOGUE^® may increase the anticoagulant effect of warfarin.

Please see Zegalogue^® Full Prescribing Information.

References: 1. American Diabetes Association. 6. Glycemic targets: Standards of Medical Care in Diabetes—2021. Diabetes Care. 2021;44(suppl 1):S73-S84. doi:10.2337/dc21-S006 2. Cobb E, Watson N, Wardian J, Morrow C, Sauerwein T. Glucagon kits: are your patients prepared for a hypoglycemic emergency? AADE in Practice. 2017;5(1):12-17. doi:10.1177/2325160316677575 3. International Hypoglycaemia Study Group. Minimizing hypoglycemia in diabetes. Diabetes Care. 2015;38(8):1583-1591. doi:10.2337/dc15-0279 4. Zegalogue (dasiglucagon). Prescribing information. Zealand Pharma A/S; April 2021.