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Reactive hypoglycemia, postprandial hypoglycemia, or sugar crash is a term describing recurrent episodes of symptomatic hypoglycemia occurring within four hours [1] after a high carbohydrate meal in people with and without diabetes. [2]
While the treatment of hypoglycemia is typically managed with carbohydrate consumption, glucagon injection, or dextrose administration, there are some other treatments available. [3] Medications like diazoxide and octreotide decrease insulin levels, increasing blood glucose levels. [ 3 ]
Drugs used in diabetes treat types of diabetes mellitus by decreasing glucose levels in the blood.With the exception of insulin, most GLP-1 receptor agonists (liraglutide, exenatide, and others), and pramlintide, all diabetes medications are administered orally and are thus called oral hypoglycemic agents or oral antihyperglycemic agents.
In diabetics, hypoglycemia can occur as a result of too much insulin or antidiabetic medication, insufficient food intake, or sudden increase in physical activity or exercise. The most common glucose-elevating agents used to treat diabetic hypoglycemia are glucose (in the form of tablets or liquid) and glucagon injections when severe ...
The incidence of hypoglycemia due to complex drug interactions, especially involving oral hypoglycemic agents and insulin for diabetes, rises with age. Though much rarer, the incidence of insulin-producing tumors also rises with advancing age. Most tumors causing hypoglycemia by mechanisms other than insulin excess occur in adults. [citation ...
A 2014 review found increased risk of heart failure with saxagliptin and alogliptin, prompting the FDA in 2016 to add warnings to the relevant drug labels. [22] A 2018 meta analysis showed that use of DPP-4 inhibitors was associated with a 58% increased risk of developing acute pancreatitis compared with placebo or no treatment. [23]
As a result, different GLP-1 agonist drugs are modified in various ways to extend the half-life, resulting in drugs that can be dosed multiple times per day, daily, weekly, or less often. [29] Most synthetic GLP-1 agonists are delivered via subcutaneous injection , which is a barrier to their use and reason for discontinuation. [ 37 ]
For many, the current standard of care (the glucagon emergency kit) is burdensome and not caregiver or patient-friendly due to the multiple steps required to administer the drug, especially during an emergency situation. [7] To improve hypoglycemia treatment, many companies are developing more efficient glucagon delivery solutions.
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