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Glucagon-blocking drug reduces need for insulin, improves blood glucose levels in T1D patients

Audrey Abella
one month ago

A single dose of the human glucagon receptor (GCGR) antibody, REMD-477, reduces the amount of insulin necessary and significantly improves glycaemic control in individuals with type 1 diabetes (T1D), according to a study presented at the ADA 2017 in San Diego, California, US.

“[P]eople with [T1D] produce too much glucagon … Our study strongly supports the long-held theory that blocking glucagon may have a significant clinical impact on care for people with [T1D] by improving glucose levels and lowering insulin doses,” said Dr Jeremy Pettus from the University of California, San Diego, California, US.

In this double-blind study on 21 adults with T1D, patients were randomized to receive a single subcutaneous injection of REMD-477 (70 mg, n=10) or placebo injection (n=11) on day 2 of a 5-day, inpatient observation period. [ADA 2017, abstract 378-OR]

Glucose levels were measured using Continuous Glucose Monitoring prior to and 8 weeks after admission. Participants were given standardized meals and constant intravenous insulin infusion to help maintain glucose levels.

On day 4, REMD-477 administration resulted in a 26 percent (12 units) reduction in insulin levels vs placebo (p=0.02). “Exposure to this [GCGR] significantly reduced insulin requirements during inpatient stay,” said Pettus.

Furthermore, during the three weekly periods after inpatient evaluation, there was a significant improvement in blood sugar levels as the average daily glucose concentration in REMD-477-treated patients was 20–31 mg/dL lower than the placebo group (p<0.05), with less insulin use.

Pettus underlined that if the difference in blood sugar levels persisted, it would be equivalent to a HbA1C drop of about 1 percent, which translates to a substantial change in glucose profiles.

Outpatient glycaemic control evaluation during the second treatment week (days 6–12) showed a statistically significant increase in time-in-range in the REMD-477 vs placebo group (71 vs 56 percent).

Overall, these findings demonstrate that a single REMD-477 injection effectively reduced total daily insulin requirements while improving glucose control, with no episodes of severe hypoglycaemia, said the researchers.

“We expected that [REMD-477] would have an effect, yet the degree to which the drug reduced the need for insulin and improved patients’ blood sugar levels without increasing hypoglycaemia events was a surprise,” said Pettus.

As the study measured the glucagon-blocking effect after one injection only, Pettus indicated that a follow-up study has been initiated to evaluate long-term treatment using different dose strengths in order to determine the impact of REMD-477 on blood glucose levels, insulin use, and weight in an outpatient setting.

 

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3 years ago

WHO (2012) estimates that around 450 million people suffer from mental illness, with one–in–four families having at least one member with a mental illness at any point in time. According to the Malaysian Mental Health Association, mental illness is often misunderstood. For centuries, it has been seen as either possession by evil spirits, a moral weakness or punishment from a higher being. Those suffering from mental illness are commonly perceived to be restless, violent and unpredictable.

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