The News:

Scientists concluded that adolescents diagnosed with T1D lose glucagon function as early as a month after diagnosis and, on average, 8 months after diagnosis.

Meanwhile, researchers from the Oregon Health & Science University announced the ability to formulate a more stable, artificial, liquid glucagon.

What This Means for the T1D Community:

Treating T1D with insulin alone is like trying to drive a car with seriously faulty brakes. Sure, insulin will keep the car moving. And yes, we can try to try to ease up on the gas in preparation for the curve ahead and we can steer carefully and white-knuckle each stretch to navigate the road with minimal skid-out, but wouldn’t it be easier to depress a pedal that would give us confidence that we would make a safe, tight turn?

A more stable, artificial, liquid glucagon, like the one formulated at the Oregon Health & Science University, would allow us this kind of control.

When Will was newly diagnosed, I got sort of fixated on the fact that my kid still had a decent braking system in his pancreatic automobile.

“You don’t need to worry too much,” said Dr. Neely, who inspired calm during the early, panicky clinic appointment when I complained about a nighttime low that was probably very benign but terrifying at the time, like, say, a 68. “He’s still got pretty decent glucagon production at this point. You’ve got a pretty wide safety net.”

What Dr. Neely meant was that Will’s pancreas was probably still pretty good at secreting glucagon. When too much insulin caused a serious drop in blood glucose, glucagon was a natural antidote made by the pancreas that meant stored glycogen–another form of glucose–was released from the liver and my twelve-year-old’s blood glucose would rise.

New research this month means that Dr. Neely was spot on. If the average T1D adolescent loses glucagon production 8 months after diagnosis–the 24 kids in the study were 14 years old–then Will’s nighttime lows probably were buffered by glucagon.

For the vast majority of people living with T1D, though, the early days of the glucagon buffer–so comforting to this mom–are long over.

What I want is a glucagon come back!

People who are really adept at diabetes care understand that “mini-glucagon” injections can be very useful in regulating blood glucose.

Later generation artificial pancreases are already slated to work with glucagon in addition to insulin.

But for glucagon to become more a part of any T1D regimen, we need to get the hormone out of the alarming red plastic cases with the powder in the vial and the thick-needled syringe that scream “Emergency Use Only!”

We need a glucagon that can remain stable in a liquid form: in a pump, or on the shelf of the fridge, or in the liquor cabinet, which is where–oddly–we store any current open vial of Humalog.

While more studies need to be completed before the new formulation of glucagon can be approved, and while the news that teens lose their glucagon function around 8 months post-diagnosis is just one piece of the T1D information puzzle, both these studies bring us one step closer to a much better braking system for this most important machine.

If You Want to Read More:

http://care.diabetesjournals.org/content/early/2012/06/11/dc11-2010.abstract?sid=8e4fe84b-b8c3-4357-a8cb-871560a45b87

http://medicalxpress.com/news/2012-06-early-loss-glucagon-response-hypoglycemia.html

https://www.jdrf.org/index.cfm?page_id=117249

http://www.ohsu.edu/xd/about/news_events/news/2012/06-11-stable-liquid-glucagon.cfm