GLUCOSE RECOVERY AFTER INTRANASAL GLUCAGON DURING HYPOGLYCEMIA IN MAN

We compared the hyperglycaemic effect of intranasal and intramuscular (i.m.) administration of glucagon after insulin-induced hypoglycaemia. Twelve healthy subjects were examined twice, receiving on both occasi ons an intravenous insulin bolus. Somatostatin and propranolol were ad ministered to block endogenous glucose counterregulation, and glucose turnover was estimated by a 3-[H-3]-glucose infusion. When hypoglycaem ia was reached, the subjects received either i.m. glucagon of pancreat ic extraction (1 mg) or intranasal genetically engineered glucagon (2 mg). The incremental values for plasma glucose concentrations 15 min a fter intranasal and i.m. administration of glucagon differed marginall y. However, after 5 min the glucose appearance rate, as well as the in cremental values for plasma glucose, were significantly higher for the i.m. glucagon treatment. The mean time taken for incremental plasma g lucose to exceed 3 mmol.1(-1) was significantly shorter for i.m. gluca gon. The mean plasma glucagon level increased faster after i.m. glucag on than after intranasal glucagon, and the levels remained higher thro ughout the study period. We conclude that glucose recovery was signifi cantly better after i.m. administration of glucagon than after intrana sal administration. However, the differences between the incremental p lasma glucose and the time for incremental plasma glucose to exceed 3 mmol.1(-1) were not considered of major clinical importance.