Baqsimi ® (glukagon näspulver)

För fullständig produktresumé för Baqsimi® se FASS.

Denna information är endast avsedd för sjukvårdspersonal verksam i Sverige och som svar på din fråga. Informationen nedan är på engelska

Baqsimi® (glukagon näspulver): Glykogenlager

Tillräckligt med leverglykogen måste finnas för att glukagon näspulver ska behandla hypoglykemi effektivt.

Detailed Information

Glucagon increases BG concentration by activating hepatic glucagon receptors, thereby stimulating

  • hepatic glycogen breakdown and

  • the release of glucose from the liver.1

NG is effective in treating hypoglycemia only if sufficient hepatic glycogen is present.1

Because glucagon is of little or no help in states of starvation, adrenal insufficiency, or chronic hypoglycemia, patients with these conditions should be treated with glucose.1

Regulation of Glucose and Breakdown of Glycogen

Insulin and glucagon are glucose-dependent counterregulatory hormones secreted from the pancreas that work to maintain glycemia within normal ranges by controlling rates of glucose use and production.2

The liver plays a main role in maintaining glucose homeostasis by maintaining a balance between glucose production and storage of glucose in the form of glycogen.2

In the fed state, blood glucose concentrations increase and insulin is released from the pancreatic β-cells. This causes glucose absorption to be stored as glycogen in the liver and suppresses hepatic glucose production. The increased insulin levels suppress glucagon secretion from the pancreatic α-cells.2

In the fasted state, insulin levels decrease and glucagon is secreted from the pancreatic α-cells. This causes hepatic glucose production to supply glucose to the body and meet the body's energy needs. The increased glucagon levels suppress insulin release from the pancreatic β-cells.2

Hepatic glucose is produced by

  • glycogenolysis or glycogen breakdown to glucose, and

  • gluconeogenesis or endogenous glucose production.2

Glycogen stored in the liver is limited and can be depleted in certain medical conditions, during longer-term fasting or starvation, and after vigorous or prolonged exercise.2-5 In situations of glycogen depletion, glycogen stores may not be adequate for administered glucagon to be effective in treating hypoglycemia.6

References

1. Baqsimi [summary of product characteristics]. Eli Lilly Nederland B.V., The Netherlands.

2. Sharabi K, Tavares CD, Rines AK, Puigserver P. Molecular pathophysiology of hepatic glucose production. Mol Aspects Med. 2015;46:21-33. https://doi.org/10.1016/j.mam.2015.09.003

3. Trefts E, Williams AS, Wasserman DH. Exercise and the regulation of hepatic metabolism. Prog Mol Biol Transl Sci. 2015;135:203-225. https://doi.org/10.1016/bs.pmbts.2015.07.010

4. Han HS, Kang G, Kim JS, et al. Regulation of glucose metabolism from a liver-centric perspective. Exp Mol Med. 2016;48:e218. https://doi.org/10.1038/emm.2015.122

5. Holloszy JO, Kohrt WM. Regulation of carbohydrate and fat metabolism during and after exercise. Annu Rev Nutr. 1996;16:121-138. https://doi.org/10.1146/annurev.nu.16.070196.001005

6. Data on file, Eli Lilly and Company and/or one of its subsidiaries.

Glossary

BG = blood glucose

NG = nasal glucagon (glucagon nasal powder)

Datum fӧr senaste ӧversyn 2019 M09 06


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