Trial reportDiabetes care2014
Quantification of the glycemic response to microdoses of subcutaneous glucagon at varying insulin levels.
Trial report in Diabetes care, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
19 citing papers in PubMed, 51 citations in OpenAlex.
- Low doses of dasiglucagon consistently increase plasma glucose levels from hypoglycaemia and euglycaemia in people with type 1 diabetes mellitus.Diabetes, obesity & metabolism · 2019Trial
- Glucagon sensitivity and clearance in type 1 diabetes: insights from in vivo and in silico experiments.American journal of physiology. Endocrinology and metabolism · 2015Trial
- The 'Designer' Artificial Pancreas: How Does Current Technology Mimic Pancreatic Physiology?Cureus · 2025Review
- The role of pancreas to improve hyperglycemia in STZ-induced diabetic rats by thiamine disulfide.Nutrition & diabetes · 2022Article
- Vasodilatory effects of glucagon: A possible new approach to enhanced subcutaneous insulin absorption in artificial pancreas devices.Frontiers in bioengineering and biotechnology · 2022Article
- Adjunctive Therapies to Optimize Closed-loop Glucose Control.Journal of diabetes science and technology · 2021Article
- Dual-hormone artificial pancreas for management of type 1 diabetes: Recent progress and future directions.Artificial organs · 2021Review
- Pharmacokinetics of Intraperitoneally Delivered Glucagon in Pigs: A Hypothesis of First Pass Metabolism.European journal of drug metabolism and pharmacokinetics · 2021Article
- Intraperitoneal and subcutaneous glucagon delivery in anaesthetized pigs: effects on circulating glucagon and glucose levels.Scientific reports · 2020Article
- Role of Glucagon in Automated Insulin Delivery.Endocrinology and metabolism clinics of North America · 2020Review
- Parallel Control of an Artificial Pancreas with Coordinated Insulin, Glucagon, and Rescue Carbohydrate Control Actions.Journal of diabetes science and technology · 2019Article
- Insulin-and-Glucagon Artificial Pancreas Versus Insulin-Alone Artificial Pancreas: A Short Review.Diabetes spectrum : a publication of the American Diabetes Association · 2019Article
- Glucagon Receptor Signaling and Glucagon Resistance.International journal of molecular sciences · 2019Review
- New uses and formulations of glucagon for hypoglycaemia.Drugs in context · 2019Review
- Cross-Validation of a Glucose-Insulin-Glucagon Pharmacodynamics Model for Simulation Using Data From Patients With Type 1 Diabetes.Journal of diabetes science and technology · 2017Article
- Glucagon responses to exercise-induced hypoglycaemia are improved by somatostatin receptor type 2 antagonism in a rat model of diabetes.Diabetologia · 2016Article
- Effect of Repeated Glucagon Doses on Hepatic Glycogen in Type 1 Diabetes: Implications for a Bihormonal Closed-Loop System.Diabetes care · 2015Article
- Incorporating an Exercise Detection, Grading, and Hormone Dosing Algorithm Into the Artificial Pancreas Using Accelerometry and Heart Rate.Journal of diabetes science and technology · 2015Article
- Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors at 3 institutions in 2 countries.
Funding
Abstract
objectiveGlucagon delivery in closed-loop control of type 1 diabetes is effective in minimizing hypoglycemia. However, high insulin concentration lowers the hyperglycemic effect of glucagon, and small doses of glucagon in this setting are ineffective. There are no studies clearly defining the relationship between insulin levels, subcutaneous glucagon, and blood glucose. RESEARCH DESIGN AND
methodsUsing a euglycemic clamp technique in 11 subjects with type 1 diabetes, we examined endogenous glucose production (EGP) of glucagon (25, 75, 125, and 175 μg) at three insulin infusion rates (0.016, 0.032, and 0.05 units/kg/h) in a randomized, crossover study. Infused 6,6-dideuterated glucose was measured every 10 min, and EGP was determined using a validated glucoregulatory model. Area under the curve (AUC) for glucose production was the primary outcome, estimated over 60 min.
resultsAt low insulin levels, EGP rose proportionately with glucagon dose, from 5 ± 68 to 112 ± 152 mg/kg (P = 0.038 linear trend), whereas at high levels, there was no increase in glucose output (19 ± 53 to 26 ± 38 mg/kg, P = NS). Peak glucagon serum levels and AUC correlated well with dose (r2 = 0.63, P < 0.001), as did insulin levels with insulin infusion rates (r2 = 0.59, P < 0.001).
conclusionsEGP increases steeply with glucagon doses between 25 and 175 μg at lower insulin infusion rates. However, high insulin infusion rates prevent these doses of glucagon from significantly increasing glucose output and may reduce glucagon effectiveness in preventing hypoglycemia when used in the artificial pancreas.
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.