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): Insulinom

Administrering av glukagon näspulver till en person med insulinom kan initialt höja blodsocker och sedan orsaka överdriven frisättning av insulin från insulinomet och orsaka hypoglykemi.

Detailed Information

NG has not been studied in people with insulinoma.

In patients with insulinoma, administration of glucagon may produce an initial increase in blood glucose; however, glucagon administration may directly or indirectly (through an initial rise in blood glucose) stimulate exaggerated insulin release from an insulinoma and cause hypoglycaemia. A patient developing symptoms of hypoglycaemia after a dose of glucagon should be given glucose orally or intravenously.1

Tumor-Induced Hypoglycemia

Hypoglycemia is typically an inhibitor of insulin secretion.2

Tumor-induced hypoglycemia is a clinical type of hypoglycemia caused by hyperinsulinism.3,4 The most common cause of tumor-induced hypoglycemia is an insulinoma, which is the most common neuroendocrine tumor of the pancreas.3,4 Insulinoma leads to hypoglycemia by causing inappropriate, but not necessarily excessive, release of insulin.2

The most characteristic biochemical feature of an insulinoma is the lack of suppression of insulin secretion in response to hypoglycemia and is indicated by the measurement of plasma insulin and BG concentrations.2,5

Treatment of insulinoma-associated hypoglycemia includes

  • oral glucose or fast-acting carbohydrates for mild hypoglycemia or conscious people

  • 50% glucose administered IV or 1 mg glucagon administered IM or SC for severe hypoglycemia or unconscious people, or

  • IV infusion of 10% or 20% glucose or enteral nocturnal feeding for recurrent hypoglycemia.4

It is important to be aware that the administration of injectable glucagon in people with an insulinoma may cause exaggerated insulin secretion from the insulinoma tumor cells and result in severe hypoglycemia.5

Glucagon for Diagnosis of Insulinoma

NG has not been studied as an aid in diagnosis of insulinoma.

Injectable glucagon has been used in aiding in the diagnosis of insulinoma by measuring the glucose response and serum insulin levels following IM or IV administration.2,5-7 

References

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

2. Marks V. Diagnosis of insulinoma. Gut. 1971;12(10):835-843.

3. Iglesias P, Diez JJ. A clinical update on tumor-induced hypoglycemia. Eur J Endocrinol. 2014;170(4):R147-R157. https://doi.org/10.1530/EJE-13-1012

4. Matej A, Bujwid H, Wronski J. Glycemic control in patients with insulinoma. Hormones. 2016;15(4):489-499. https://doi.org/10.14310/horm.2002.1706

5. Soh A, Kek PC. Insulinoma in a patient with normal results from prolonged fast and glucagon-induced hypoglycemia. Endocr Pract. 2010; 16(5):838-841. https://doi.org/10.4158/EP10073.CR

6. Marks V, Samols E. Glucagon test for insulinoma: a chemical study in 25 cases. J Clin Path. 1968;21(3):346-352. https://doi.org/10.1136/jcp.21.3.346

7. Samols E, Marri G, Marks V. Promotion of insulin secretion by glucagon. Lancet. 1965;286(7409):415-416. https://doi.org/10.1016/s0140-6736(65)90761-0

Glossary

BG = blood glucose

IM = intramuscular

IV = intravenous

NG = nasal glucagon (glucagon nasal powder)

SC = subcutaneous

Datum fӧr senaste ӧversyn 2019 M08 28


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