Top

Current Diabetes Reports

Published in:

01-04-2022 | Hypoglycemia | Psychosocial Aspects (J Pierce, Section Editor)

Emergency Glucagon: a Focused Review of Psychosocial Experiences of Rescue Drugs for Type 1 Diabetes

Authors: Katherine Chapman, Allyson S. Hughes, Jeoffrey Bispham, Carolina Leon, Huyen Nguyen, Wendy A. Wolf

Published in: Current Diabetes Reports | Issue 4/2022

Abstract

Purpose of Review

The purpose of this paper is to describe rescue glucagon types, safety, efficacy, and preferences, as well as to review articles regarding emergency glucagon usage, severe hypoglycemia, and the emotions of both phenomena. We conducted a review of current literature on glucagon usage and the emotional impact of severe hypoglycemia on people with diabetes (PwD) and the caregivers of people with type 1 diabetes (T1D).

Recent Findings

Minimal research exists pertaining to glucagon and severe hypoglycemic experiences in PwD, which is troubling considering the severity of risks and possible side effects. Recent articles described negative emotions such as fear, anxiety, stress, helplessness, shame, embarrassment, loneliness, frustration, hopefulness, and uncertainty surrounding glucagon usage.

Summary

There is scarce research regarding PwD’s emotions surrounding severe hypoglycemia and rescue glucagon use. Additional research is needed to investigate the emotions and feelings people with T1D and their caregivers’ experience pertaining to severe hypoglycemia and emergency glucagon use.

Type 1 diabetes facts. JDRF. https://www.jdrf.org/t1d-resources/about/facts/. Accessed 16 Aug 2021.

American Diabetes Association. Defining and reporting hypoglycemia in diabetes: a report from the American Diabetes Association Workgroup on Hypoglycemia. Diabetes Care. 2005;28(5):1245–9.CrossRef

McCrimmon RJ, Sherwin RS. (2010). Hypoglycemia in type 1 diabetes. Diabetes, 2010:59(10):2333–2339. https://doi.org/10.2337/db10-0103

Liu J, Bispham J, Fan L, Poon JL, Hughes A, Mcauliffe-Fogarty A, Varnado O, Mitchell B. Factors associated with fear of hypoglycaemia among the T1D Exchange Glu population in a cross-sectional online survey. BMJ Open. 2020;10(9): e038462. https://doi.org/10.1136/bmjopen-2020-038462.CrossRefPubMedPubMedCentral

Pratley RE, Kanapka LG, Rickels MR, Ahmann A, Aleppo G, Beck R, Bhargava A, Bode BW, Carlson A, Chaytor NS, Fox DS, Goland R, Hirsch IB, Kruger D, Kudva YC, Levy C, McGill JB, Peters A, Philipson L, Philis-Tsimikas A. … Wireless Innovation for Seniors With Diabetes Mellitus (WISDM) study group effect of continuous glucose monitoring on hypoglycemia in older adults with type 1 diabetes: a randomized clinical trial. JAMA. 2020;323(23):2397–406. https://doi.org/10.1001/jama.2020.6928.CrossRefPubMedPubMedCentral

Amiel SA. Hypoglycemia: From the laboratory to the clinic. Diabetes Care. 2016;32(8):1364–71. https://doi.org/10.2337/dc09-0113.CrossRef

Haymond MW, Liu J, Bispham J, Hickey A, McAuliffe-Fogarty AH. Use of Glucagon in Patients With Type 1 Diabetes. Clin Diabetes. 2019;37(2):162–6. https://doi.org/10.2337/cd18-0028.CrossRefPubMedPubMedCentral

Kedia N. Treatment of severe diabetic hypoglycemia with glucagon: an underutilized therapeutic approach. Diabetes Metab Syndr Obes. 2011;4:337–46. https://doi.org/10.2147/DMSO.S20633.CrossRefPubMedPubMedCentral

Hughes A, Chapman K, Bispham J, Dimsits J, Weinzimer S, Wolf W, Heydarian N. (IP02) Severe Hypoglycemia Rescue Drugs: Perspectives of People with Diabetes and Emergency Glucagon Usage. Presented at the Association of Diabetes Care & Education Specialists Annual Conference, Aug 12–15, 2021.

10.

Hughes A, Chapman K., Bispham J., Dimsits J, Weinzimer S, Wolf W, Nguyen H, Liu J. (IP01) Perspectives of People with Diabetes on Emergency Glucagon Usage: An Observational Survey from the T1D Exchange Registry. Presented at the Association of Diabetes Care & Education Specialists Annual Conference, Aug 12–15, 2021.

11.

GVOKE [package insert]. 180 North LaSalle Street, Suite 1600, Chicago, IL 60601; Xeris Pharmaceuticals, Inc., 2019.

12.

Baqsimi [package insert]. Indianapolis, IN: Eli Lilly and Company; 2019.

13.

Fidler C, Elmelund CT, Gillard S. Hypoglycemia: an overview of fear of hypoglycemia, quality-of-life, and impact on costs. J Med Econ. 2011;14(5):646–55. https://doi.org/10.3111/13696998.2011.610852.CrossRefPubMed

14.

Muradoğlu S, Yeşiltepe Mutlu G, Gökçe T, Can E, Hatun Ş. An evaluation of glucagon injection anxiety and its association with the fear of hypoglycemia among the parents of children with type 1 diabetes. J Clin Res Pediatr Endocrinol, 2021:Epub ahead of print. https://doi.org/10.4274/jcrpe.galenos.2021.2020.0191.

15.

Patton SR, Dolan LM, Henry R, Powers SW. Parental fear of hypoglycemia: young children treated with continuous subcutaneous insulin infusion. Pediatr Diabetes. 2007;8(6):362–8. https://doi.org/10.1111/j.1399-5448.2007.00242.x.CrossRefPubMed

16.

Patton SR, Dolan LM, Smith LB, Thomas IH, Powers SW. Pediatric parenting stress and its relation to depressive symptoms and fear of hypoglycemia in parents of young children with type 1 diabetes mellitus. J Clin Psychol Med Settings. 2011;18(1):345–52. https://doi.org/10.1007/s10880-011-9256-1.CrossRefPubMedPubMedCentral

17.

18.

FDA News Release. (2020). FDA approves first generic of drug used to treat severe hypoglycemia; agency supports development of complex generic drugs to improve competition and access to more affordable medicines. US Food & Drug Administration.

19.

Elliott, W, Chan, J. Glucagon nasal powder (Baqsimi). Internal Medicine Alert, 2019:41(16).

20.

Quattrocchi E. New formulations of glucagon for the treatment of severe hypoglycemia. J Nurse Pract. 2020;16(1):85–6. https://doi.org/10.1016/j.nurpra.2019.09.015.CrossRef

21.

Deeb LD, Dulude H, Guzman CB, Zhang S, Reiner BJ, Piché CA, Pradhan S, Zhang XM. A phase 3 multicenter, open-label, prospective study designed to evaluate the effectiveness and ease of use of nasal glucagon in the treatment of moderate and severe hypoglycemia in children and adolescents with type 1 diabetes in the home or school setting. Pediatr Diabetes. 2018;19(5):1007–13. https://doi.org/10.1111/pedi.12668.CrossRefPubMed

22.

Pontiroli AE, Alberetto M, Pozza G. Intranasal glucagon raises blood glucose concentrations in healthy volunteers. Br Med J (Clin Res Ed). 1983;287(6390):462–3. https://doi.org/10.1136/bmj.287.6390.462-a.CrossRef

23.

Sherr JL, Ruedy KJ, Foster NC, Piché CA, Dulude H, Rickels MR, Tamborlane WV, Bethin KE, DiMeglio LA, Fox LA, Wadwa RP, Schatz DA, Nathan BM, Marcovina SM, Rampakakis E, Meng L, Beck RW. Glucagon nasal powder: a promising alternative to intramuscular glucagon in youth with type 1 diabetes. Diabetes Care. 2016;39(4):555–62. https://doi.org/10.2337/dc15-1606.CrossRefPubMedPubMedCentral

24.

Seaquist ER, Dulude H, Zhang XM, Rabasa-Lhoret R, Tsoukas GM, Conway JR, Weisnagel SJ, Gerety G, Woo VC, Zhang S, Carballo D, Pradhan S, Piché CA, Guzman CB. Prospective study evaluating the use of nasal glucagon for the treatment of moderate to severe hypoglycaemia in adults with type 1 diabetes in a real-world setting. Diabetes Obes Metab. 2018;20(5):1316–20. https://doi.org/10.1111/dom.13278.CrossRefPubMedPubMedCentral

25.

Heba SF, Parveen U, Khanum SS, Gulnaaz M, Tabassum M, Safiyya SB. Nasal glucagon: A new hope for severe hypoglycemia in type 1 diabetes. J Diabetes Endocr Pract. 2021;4(1):13–8. https://doi.org/10.4103/jdep.jdep_6_20.CrossRef

26.

Lowe RN, Trujillo JM. Intranasal glucagon: a new way to treat hypoglycemic emergencies. Ann Pharmacother. 2020;54(8):780–7. https://doi.org/10.1177/1060028020905846.CrossRefPubMed

27.

Pontiroli AE. Intranasal glucagon for hypoglycaemia in diabetic patients. An old dream is becoming reality?. Diabetes Obes Metab 2018:20(8):1812–1816. https://doi.org/10.1111/dom.13317

28.

Pontiroli AE, Tagliabue E. Therapeutic use of intranasal glucagon: resolution of hypoglycemia. Int J Mol Sci 2019:20(15). https://doi.org/10.3390/ijms20153646

29.

• Suico JG, Hövelmann U, Zhang S, Shen T, Bergman B, Sherr J, Zijlstra E, Frier BM, Plum-Mörschel L. Glucagon Administration by Nasal and Intramuscular Routes in Adults With Type 1 Diabetes During Insulin-Induced Hypoglycaemia: A Randomised, Open-Label Crossover Study. Diabetes Therapy. 2020;11(7):1591–603. https://doi.org/10.1007/s13300-020-00845-7. This recent study is important because it showed that intranasal glucagon was just as effective as intranasal glucagon, replicating the findings from Rickels et al. (2016).CrossRefPubMedPubMedCentral

30.

• Aranishi T, Nagai Y, Takita Y, Zhang S, Nishimura R. Usability of Nasal Glucagon Device: Partially Randomized Caregiver and Third-Party User Experience Trial with Simulated Administration at a Japanese Site. Diabetes Therapy. 2020;11(1):197–211. https://doi.org/10.1007/s13300-019-00711-1. This recent study is important because the results showed that nasal glucagon was quicker, easier to administer, and had a higher success rate of administration than the conventional emergency glucagon injection kit.CrossRefPubMed

31.

Yale J, Dulude H, Egeth M, Piché CA, Lafontaine M, Carballo D, Margolies R, Dissinger E, Shames AR, Kaplowitz N, Zhang MX, Zhang S, Guzman CB. Faster Use and Fewer Failures with Needle-Free Nasal Glucagon Versus Injectable Glucagon in Severe Hypoglycemia Rescue: A Simulation Study. Diabetes Technol Ther. 2017;19(7):423–32. https://doi.org/10.1089/dia.2016.0460.CrossRefPubMedPubMedCentral

32.

Sherman JJ, Lariccia JL. Glucagon Therapy: A Comparison of Current and Novel Treatments. Diabetes Spectr. 2020;33(4):347–51. https://doi.org/10.2337/ds19-0076.CrossRefPubMedPubMedCentral

33.

• Valentine V, Newswanger B, Prestrelski S, Andre AD, Garibaldi M. Human Factors Usability and Validation Studies of a Glucagon Autoinjector in a Simulated Severe Hypoglycemia Rescue Situation. Diabetes Technol Ther. 2019;21(9):522–30. https://doi.org/10.1089/dia.2019.0148. This recent study showed that autoinjector glucagon can be correctly, safely, and effectively administered more frequently than the conventional injectable emergency kit.CrossRefPubMedPubMedCentral

34.

Bailey TS, Willard J, Klaff LJ, Yager Stone J, Melgaard A, Tehranchi R. Dasiglucagon, a next-generation glucagon analogue, for treatment of severe hypoglycaemia via an autoinjector device: Results of a phase 3, randomized, double-blind trial. Diabetes Obes Metab. 2021:E Pub Ahead of Print. DOI: https://doi.org/10.1111/dom.14475.

35.

Newswanger B, Prestrelski S, Andre AD. Human factors studies of a prefilled syringe with stable liquid glucagon in a simulated severe hypoglycemia rescue situation. Expert Opin Drug Deliv. 2019;16(9):1015–25. https://doi.org/10.1080/17425247.2019.1653278.CrossRefPubMed

36.

Pieber TR, Aronson R, Hövelmann U, Willard J, Plum-Mörschel L, Knudsen KM, Bandak B, Tehranchi R. Dasiglucagon: A Next-Generation Glucagon Analog for Rapid and Effective Treatment of Severe Hypoglycemia Results of Phase 3 Randomized Double-Blind Clinical Trial. Diabetes Care. 2021;44(6):1361–7. https://doi.org/10.2337/DC20-2995.CrossRefPubMedPubMedCentral

37.

ZEGALOGUE [package insert]. Sydmarken 11 2860 Søborg, Denmark; Zealand Pharma A/S, March 2021.

38.

• Beato-Víbora PI, Arroyo-Díez FJ. New uses and formulations of glucagon for hypoglycaemia. Drugs in Context. 2019;8(1): 212599. https://doi.org/10.7573/dic.212599. This recent review article is important because it mentions nasal glucagon, stable forms of glucagon, as well as mini dosing before many of these forms of glucagon were FDA approved.CrossRefPubMedPubMedCentral

39.

Mitchell B, Rentz A, Kummer S, Yan Y, Heidenreich S, Krucien N, Artime E, Osumill B, Rubio M, Gelhourn H. (IP06) People With Diabetes and Caregivers Prefer Nasal Glucagon Over Conventional Injectable Glucagon: A Discrete Choice Experiment. Presented at the Association of Diabetes Care & Education Specialists Annual Conference, Aug 12–15, 2021.

40.

Bailey, NC, Dimsits J, Tehranchi R, Kendall DM, Bailey TS. 137-OR: Dasiglucagon Ready-to-Use Autoinjector Is More Reliably and Quickly Administered than Glucagon Emergency Kit (GEK). Diabetes. 2021:70(Supplement 1). https://doi.org/10.2337/db21-137-OR

41.

Bajpai SK, Cambron-Mellott MJ, Peck E, Poon JL, Wang Q, Mitchell BD, Babrowicz J, Child CJ, Raibulet NK, Beusterien K. Perceptions about glucagon delivery devices for severe hypoglycemia: qualitative research with patients, caregivers, and acquaintances. Clin Ther. 2019;41(10):2073–89. https://doi.org/10.1016/j.clinthera.2019.08.006.CrossRefPubMed

42.

Bajpai SK, Cambron-Mellott J, Raibulet NK, Peck EY, Poon, JL, Wang Q, Mitchell B, Will O, Babrowicz J, Child CJ, Beusterien K. 129-LB: Evaluation of Attitudes towards Two Glucagon Delivery Devices for Rescue Treatment of Severe Hypoglycemia. Diabetes. 2020: 69(Supplement 1). https://doi.org/10.2337/db20-129-LB

43.

Haymond MW, Schreiner B. Mini-dose glucagon rescue for hypoglycemia in children with type 1 diabetes. Diabetes Care. 2001;24(4):643–5. https://doi.org/10.2337/diacare.24.4.643.CrossRefPubMed

44.

Haymond MW, Redondo MJ, McKay S, Cummins MJ, Newswanger B, Kinzell J, Prestreiski S. Nonaqueous, Mini-dose glucagon for treatment of mild hypoglycemia in adults with type 1 diabetes: a dose-seeking study. Diabetes Care. 2016;39(3):465–8. https://doi.org/10.2337/dc15-2124.CrossRefPubMedPubMedCentral

45.

Haymond MW, DuBose SN, Rickels MR, Wolpert H, Shah VN, Sherr JL, Weinstock RS, Agarwal S, Verdejo AS, Cummins MJ, Newswanger B, Beck RW. Efficacy and safety of mini-dose glucagon for treatment of nonsevere hypoglycemia in adults with type 1 diabetes. J Clin Endocrinol Metab. 2017;102(8):2994–3001. https://doi.org/10.1210/jc.2017-00591.CrossRefPubMed

46.

Hendrieckx C, Gonder-Frederick L, Heller SR, Snoek FJ, Speight J. How has psycho-behavioural research advanced our understanding of hypoglycaemia in type 1 diabetes? Diabet Med. 2019;37(3):409–17. https://doi.org/10.1111/dme.14205.CrossRefPubMed

47.

Cigrovski Berkovic M, Bilic-Curcic I, La Grasta SL, Mrzljak A, Cigrovski V. Fear of hypoglycemia, a game changer during physical activity in type 1 diabetes mellitus patients. World J Diabetes. 2021;12(5):569–77. https://doi.org/10.4239/wjd.v12.i5.569.CrossRefPubMedPubMedCentral

48.

Gonder-Frederick L. Fear of hypoglycemia: a review. Diabetic Hypoglycemia. 2013;5(3):3–11.

49.

Wild D, von Maltzahn R, Brohan E, Christensen T, Clauson P, Gonder-Frederick L. A critical review of the literature on fear of hypoglycemia in diabetes: Implications for diabetes management and patient education. Patient Educ Couns. 2007;68(1):10–5. https://doi.org/10.1016/j.pec.2007.05.003.CrossRefPubMed

50.

Brown JB, Reichert SM, Valliere Y, Webster-Bogaert S, Ratzki-Leewing A, Ryan BL, Harris SB. Living with hypoglycemia: an exploration of patients’ emotions: qualitative findings from the inHypo-DM study. Canada Diabetes Spectrum. 2019;32(3):270–6. https://doi.org/10.2337/ds18-0074.CrossRefPubMed

51.

•• Mojdami D, Mitchell BD, Spaepen E, Syring K, Rabasa-Lhoret R, Punthakee Z, Snoek F, Peyrot M. Conversations and Reactions Around Severe Hypoglycemia Study: Results of Hypoglycemia Experiences in Canadian Adults With Insulin-Treated Diabetes and Their Caregivers. Can J Diabetes. 2021;45(3):236–42. https://doi.org/10.1016/j.jcjd.2020.08.104. This study is very important because it’s some of the only recent research on the emotional impact of severe hypoglycemia and on PwD their caregivers.CrossRefPubMed

52.

Willemse M, Deacon E, Segal D. Life stories managing chronic illness: Young adults’ lived experiences with type 1 diabetes. J Psychol Afr. 2018;28(4):336–9.CrossRef

53.

•• Hughes A, Chapman, KSM, Bispham J, Heydarian NM, Dimsits J, Weinzeimer SA, Wolf W. 51-LB: emotional impact of hypoglycemia and use of glucagon: perspectives of people with T1D. Diabetes, 2021:70(Supplement 1). https://doi.org/10.2337/db21-51-LB. This recent abstract is very important because it explored the emotional impact of glucagon use and severe hypoglycemia.

54.

Hughes A, Bispham J, Fuller L, Wolf W, Fitch SA, Weinzimer SA. 8-LB: Impact of hypoglycemia and use of glucagon: perspectives of people with T1D and caregivers of minors with T1D. Diabetes, 2020:69(Supplement 1). https://doi.org/10.2337/db20-8-LB

55.

•• Stuckey HL, Desai U, King SB, Popadic L, Levinson W, Kirson N, Hankosky ER, Mitchell B. 557-P: patient and caregiver experiences during severe hypoglycemia: a qualitative assessment. Diabetes, 2021:70(Supplement 1). https://doi.org/10.2337/db21-557-P. This recent poster is very important because it explored the experiences and perceptions of PwD and their caregivers during severe hypoglycemic events.

56.

Naranjo D, Suttiratana SC, Iturralde E, Barnard KD, Weissberg-Benchell J, Laffel L, Hood KK. What end users and stakeholders want from automated insulin delivery systems. Diabetes Care. 2017;40(11):1453–61.CrossRefPubMedPubMedCentral

57.

Garza KP, Jedraszko A, Weil LE, Naranjo D, Barnard KD, Laffel LM, ... & Weissberg-Benchell J. Automated insulin delivery systems: hopes and expectations of family members. Diabetes Technol Ther 2018:20(3):222–228.

58.

Papadakis JL, Anderson LM, Garza K, Feldman MA, Shapiro JB, Evans M, ... & Weissberg-Benchell J. Psychosocial aspects of diabetes technology use: the child and family perspective. Endocrinol Metab Clin; 2020:49(1):127–141.

59.

Bassi G, Mancinelli E, Di Riso D, Salcuni S. Parental Stress, Anxiety and Depression Symptoms Associated with Self-Efficacy in Paediatric Type 1 Diabetes: A Literature Review. Int J Environ Res Public Health. 2021;18(1):152. https://doi.org/10.3390/ijerph18010152.CrossRef

60.

Herbert LJ, Monaghan M, Cogen F, Streisand R. The impact of parents’ sleep quality and hypoglycemia worry on diabetes self-efficacy. Behav Sleep Med. 2015;13(4):308–23. https://doi.org/10.1080/15402002.2014.898303.CrossRefPubMed

61.

Jaser SS, Foster NC, Nelson BA, Kittelsrud JM, DiMeglio LA, Quinn M, Willi SM, Simmons JH, T1D Exchange Clinic Network. Sleep in children with type 1 diabetes and their parents in the T1D Exchange. Sleep Medicine, 2017:39:108–115. https://doi.org/10.1016/j.sleep.2017.07.005

62.

Feeley CA, Clougherty M, Siminerio L, Charron-Prochownik D, Allende AL, Chasens ER. Sleep in Caregivers of Children With Type 1 Diabetes. Diabetes Educ. 2019;45(1):80–6. https://doi.org/10.1177/0145721718812484.CrossRefPubMed

63.

Monaghan M, Herbert LJ, Cogen FR, Streisand R. Sleep Behaviors and Parent Functioning in Young Children With Type 1 Diabetes. Child Health Care. 2012;41(3):246–59. https://doi.org/10.1080/02739615.2012.685385.CrossRefPubMedPubMedCentral

64.

Pate T, Klemenčič S, Battelino T, Bratina N. Fear of hypoglycemia, anxiety, and subjective well-being in parents of children and adolescents with type 1 diabetes. J Health Psychol. 2019;24(2):209–18. https://doi.org/10.1177/1359105316650931.CrossRefPubMed

65.

Gonder-Frederick LA, Fishe CD, Ritterband LM, Cox DJ, Hou L, DasGupta AA, Clarke WL. Predictors of fear of hypoglycemia in adolescents with type 1 diabetes and their parents. Pediatr Diabetes. 2006;7(4):15–222. https://doi.org/10.1111/j.1399-5448.2006.00182.x.CrossRef

66.

Driscoll KA, Raymond J, Naranjo D, Patton SR. Fear of Hypoglycemia in Children and Adolescents and Their Parents with Type 1 Diabetes. Current Diabetes Reports, 2016:16(77). https://doi.org/10.1007/s11892-016-0762-2

67.

Patton SR, Dolan LM, Henry R, Powers SW. Fear of hypoglycemia in parents of young children with type 1 diabetes mellitus. J Clin Psychol Med Settings. 2008;15(3):252–9. https://doi.org/10.1007/s10880-008-9123-x.CrossRefPubMedPubMedCentral

68.

Haugstvedt A, Wentzel-Larsen T, Graue M, Søvik O, Rokne B. Fear of hypoglycaemia in mothers and fathers of children with Type 1 diabetes is associated with poor glycaemic control and parental emotional distress: a population-based study. Diabet Med. 2010;27(1):72–8. https://doi.org/10.1111/j.1464-5491.2009.02867.x PMID: 20121892.CrossRefPubMed

69.

Markowitz JT, Pratt K, Aggarwal J, Volkening LK, Laffel LM. Psychosocial correlates of continuous glucose monitoring use in youth and adults with type 1 diabetes and parents of youth. Diabetes Technol Ther. 2012;14(6):523–6. https://doi.org/10.1089/dia.2011.0201.CrossRefPubMedPubMedCentral

70.

Bowes S, Lowes L, Warner J, Gregory JW. Chronic sorrow in parents of children with type 1 diabetes. J Adv Nurs. 2004;65(5):991–1000. https://doi.org/10.1111/j.1365-2648.2009.04963.x.CrossRef

71.

McConville A, Noser AE, Nelson E, Clements MA, Majidi S, Patton SR. Depression as a predictor of hypoglycemia worry in parents of youth with recent-onset type 1 diabetes. Pediatr Diabetes. 2020;21(5):909–16. https://doi.org/10.1111/pedi.13039.CrossRefPubMedPubMedCentral

72.

Commissariat PV, Harrington KR, Whitehouse AL, Miller KM, Hilliard ME, Van Name M, DeSalvo DJ, Tamborlane WV, Anderson BJ, DiMeglio LA, Laffel LM. “I’m essentially his pancreas”: Parent perceptions of diabetes burden and opportunities to reduce burden in the care of children< 8 years old with type 1 diabetes. Pediatr Diabetes. 2020;21(2):377–83. https://doi.org/10.1111/pedi.12956.CrossRefPubMed

73.

Haugstvedta A, Wentzel-Larsend T, Rokneb B, Grauea M. Perceived family burden and emotional distress: similarities and differences between mothers and fathers of children with type 1 diabetes in a population-based study. Pediatr Diabetes. 2011;12(2):107–14. https://doi.org/10.1111/j.1399-5448.2010.00661.x.CrossRef

74.

Iversen AS, Graue M, Haugstvedt A, Råheim M. Being mothers and fathers of a child with type 1 diabetes aged 1 to 7 years: a phenomenological study of parents’ experiences. Int J Qual Stud Health Well-being, 2018:13(1). https://doi.org/10.1080/17482631.2018.1487758

75.

Lawton J, Waugh N, Barnard KD, Noyes K, Harden J, Stephen J, McDowell J, Rankin D. Challenges of optimizing glycaemic control in children with Type 1 diabetes: a qualitative study of parents’ experiences and views. Diabet Med. 2015;32(8):1063–70. https://doi.org/10.1111/dme.12660.CrossRefPubMed

76.

Cox DJ, Gonder-Frederick LA, Shepard JA, Campbell LK, Vajda KA. Driving safety: concerns and experiences of parents of adolescent drivers with type 1 diabetes. Pediatr Diabetes. 2012;13(6):506–9. https://doi.org/10.1111/j.1399-5448.2012.00862.x.CrossRefPubMedPubMedCentral

Title: Emergency Glucagon: a Focused Review of Psychosocial Experiences of Rescue Drugs for Type 1 Diabetes
Authors: Katherine Chapman
Allyson S. Hughes
Jeoffrey Bispham
Carolina Leon
Huyen Nguyen
Wendy A. Wolf
Publication date: 01-04-2022
Publisher: Springer US
Keywords: Hypoglycemia
Anxiety
Type 1 Diabetes
Published in: Current Diabetes Reports / Issue 4/2022
Print ISSN: 1534-4827
Electronic ISSN: 1539-0829
DOI: https://doi.org/10.1007/s11892-021-01443-y

Obesity Clinical Trial Summary

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine

Highlights from the ACC 2024 Congress

Year in Review: Pediatric cardiology

Pediatric Cardiology Video

Watch Dr. Anne Marie Valente present the last year's highlights in pediatric and congenital heart disease in the official ACC.24 Year in Review session.

Year in Review: Pulmonary vascular disease

Cardiopulmonary Comorbidity Video

The last year's highlights in pulmonary vascular disease are presented by Dr. Jane Leopold in this official video from ACC.24.

Year in Review: Valvular heart disease

Valvular Heart Disease Video

Watch Prof. William Zoghbi present the last year's highlights in valvular heart disease from the official ACC.24 Year in Review session.

Year in Review: Heart failure and cardiomyopathies

Heart Failure Video

Watch this official video from ACC.24. Dr. Biykem Bozkurt discuss last year's major advances in heart failure and cardiomyopathies.

ACC 2024 Congress Coverage

Heart Failure Video

Year in Review: Heart failure and cardiomyopathies

Watch now

Watch this official video from ACC.24. Dr. Biykem Bozkurt discuss last year's major advances in heart failure and cardiomyopathies.

Semaglutide benefits people with type 2 diabetes and obesity-related heart failure

16-04-2024 Type 2 Diabetes News

Incentivised to exercise

11-04-2024 Lifestyle Modifications News

New intervention for STEMI-related cardiogenic shock

10-04-2024 Myocardial Infarction News

» View more highlights on the ACC 2024 congress hub page

Image Credits

STEP AAG HeroTeaserCollection image/© Tarek / Generated with AI / Stock.adobe.com, ACC 2024 Pediatric and Congenital Heart Disease: Year in Review/© 2024 American College of Cardiology, ACC 2024 Pulmonary Vascular Disease: Year in Review/© 2024 American College of Cardiology, ACC 2024 Valvular Heart Disease: Year in Review/© 2024 American College of Cardiology, ACC 2024 HF and Cardiomyopathies: Year in Review/© 2024 American College of Cardiology, Woman out walking/© Seventyfour / stock.adobe.com (symbolic image with model), Woman checking smartwatch /© saltdium / stock.adobe.com (symbolic image with model), Cardiac catheterization/© Damian / stock.adobe.com

At a glance: The STEP trials

Springer Medicine

Abstract

Purpose of Review

Recent Findings

Summary

Please log in to get access to this content

Other articles of this Issue 4/2022

Integrated Behavioral Interventions for Adults with Comorbid Obesity and Depression: a Systematic Review

The Impact of Meal Timing on Risk of Weight Gain and Development of Obesity: a Review of the Current Evidence and Opportunities for Dietary Intervention

Correction to: Emergency Glucagon: a Focused Review of Psychosocial Experiences of Rescue Drugs for Type 1 Diabetes

It Is Not Just Fat: Dissecting the Heterogeneity of Adipose Tissue Function

Role of the Autonomic Nervous System in the Hemodynamic Response to Hyperinsulinemia—Implications for Obesity and Insulin Resistance

Highlights from the ACC 2024 Congress

ACC 2024 Congress Coverage