Stable, liquid glucagon formulation discovered for potential use in artificial pancreas systems
06/11/12 New York, N.Y.
JDRF-funded researchers from OHSU and Legacy Health discovered a method to stabilize liquid glucagon for automated pump delivery that could accelerate the development of a multi-hormonal, fully automated closed loop artificial pancreas system
JDRF-funded researchers at Oregon Health & Science University (OHSU) and Legacy Health have discovered a liquid glucagon formulation that may be useable in standard diabetes pumps. Such a formulation could broaden the use of glucagon to help prevent hypoglycemia in people with Type 1 diabetes who are treated with insulin. It could also open a path to future-generation artificial pancreas systems that dispense more than just insulin for optimizing glucose control.
“Our previous studies have shown that the injections of small amounts of glucagon prevent hypoglycemia, which is a frequent and serious complication of Type 1 diabetes that can lead to seizures, loss of consciousness, and even death,” said W. Kenneth Ward, M.D., associate professor of medicine (endocrinology, diabetes and clinical nutrition) at OHSU School of Medicine and senior scientist at Legacy Health, the two Portland, Ore.-based organizations that collaborated on the study. The research was presented at the American Diabetes Association’s (ADA) 72nd Scientific Sessions on Friday, June 8, and on Sunday, June 10, in Philadelphia.
Dr. Ward continues: “Current forms of glucagon cannot be kept for long periods of time in a portable pump, and therefore could not be used as part of an artificial pancreas system. While it is important to note that additional studies will be undertaken in animals and humans before FDA approval can be sought, we have found that the alkaline glucagon compound we discovered can be kept in liquid form for long periods of time, potentially opening pathways for use in bi-hormonal diabetes pumps and toward better therapies for people with diabetes.”
The research is a key step forward toward the routine delivery of glucagon for people with Type 1 diabetes, and toward the development of a multi-hormonal, fully automated closed loop artificial pancreas system. Such future-generation artificial pancreas systems would automatically deliver both insulin and glucagon, or other drugs.
Glucagon is a naturally occurring hormone that responds to hypoglycemia (extreme low blood sugar) by raising blood sugars, but its regulation is impaired in people with Type 1 diabetes. It works to complement the function of insulin to provide the natural fine-tuning of blood glucose control. Previous studies have shown that the addition of glucagon to insulin treatment reduces the frequency of hypoglycemia in Type 1 diabetes, more closely mimicking the physiology of someone without diabetes.
Commercially available glucagon does not maintain its liquid form after the powder and solution are combined, making it suitable only for immediate use. Dr. Ward and his team found that raising the pH of the glucagon allowed the hormone to maintain liquid form, and concluded that this formulation could be suitable for use in a closed-loop bi-hormonal pump.
“We have seen very promising results in our studies of artificial pancreas systems that utilize both insulin and glucagon. But for people with diabetes to realize this potential benefit, we need glucagon that is stable and can be used in a pump,” said Sanjoy Dutta, Ph.D., JDRF’s senior director of treat therapies. “Dr. Ward's research is promising and steers us toward more tangible solutions along the path toward a multi-hormonal, fully-automated closed loop artificial pancreas.”
The artificial pancreas combines a continuous glucose monitor (CGM) and an insulin pump via sophisticated computer software, to provide the right amount of insulin at the right times for people with diabetes. In March, the U.S. Food and Drug Administration approved the first artificial pancreas outpatient trial in the United States. Researchers envision future generations of the device to automatically deliver more than one hormone, in addition to insulin, to more closely perform the functions of a non-diabetic human pancreas.
ABOUT TYPE 1 DIABETES
In Type 1 diabetes, a person's pancreas stops producing insulin, a hormone that enables people to get energy from food. People with Type 1 diabetes need to test their blood sugar and give themselves insulin (with injections or an insulin pump) multiple times every day, and carefully balance insulin doses with eating and daily activities throughout the day and night. However, insulin is not a cure for diabetes, and even with that intensive care, a significant portion of the day is still spent with either high or low blood sugar, placing people with Type 1 diabetes at risk for devastating complications such as heart attack, stroke, blindness, and amputation.
JDRF is the leading global organization focused on Type 1 diabetes research. Driven by passionate, grassroots volunteers connected to children, adolescents, and adults with this disease, JDRF is the largest charitable supporter of Type 1 diabetes research. The goal of JDRF is to improve the lives of all people affected by Type 1 diabetes by accelerating progress on the most promising opportunities for curing, better treating, and preventing Type 1 diabetes. JDRF collaborates with a wide spectrum of partners who share this goal.
Since its founding in 1970, JDRF has awarded more than $1.6 billion to Type 1 diabetes research. More than 80 percent of JDRF's expenditures directly support research and research-related education. Past JDRF research efforts have helped to significantly improve the care of people with this disease, and have expanded the critical scientific understanding of Type 1 diabetes. JDRF will not rest until Type 1 diabetes is fully conquered.
ABOUT LEGACY HEALTH
Legacy Health is an Oregon-based nonprofit, tax-exempt organization and, with more than 9,800 employees, is one of the largest private sector employers in the Portland metropolitan area. Legacy Health provides an integrated network of healthcare services, including acute and critical care, inpatient and outpatient treatment, community health education and a variety of specialty services. Legacy's hospitals include: Legacy Emanuel Medical Center and Randall Children's Hospital, Legacy Good Samaritan Medical Center, Legacy Meridian Park Medical Center, Legacy Mount Hood Medical Center, and Legacy Salmon Creek Medical Center in Vancouver, Wash. Also included in the Legacy system are a hospice agency, a full-service research facility, and specialty and primary care clinics.
Oregon Health & Science University is the state's only health and research university and its only academic health center. As Portland's largest employer, OHSU's size contributes to its ability to provide many services and community support activities not found anywhere else in the state. OHSU serves patients from every corner of the state and is a conduit for learning for more than 4,300 students and trainees. OHSU is the source of more than 200 community outreach programs that bring health and education services to each county in the state.