Vasodilatory effects of glucagon: A possible new approach to enhanced subcutaneous insulin absorption in artificial pancreas devices

Ingrid Anna Teigen, Misbah Riaz, Marte Kierulf Åm, Sverre Christian Christiansen, Sven Magnus Carlsen, Ingrid Anna Teigen, Misbah Riaz, Marte Kierulf Åm, Sverre Christian Christiansen, Sven Magnus Carlsen

Abstract

Patients with diabetes mellitus type 1 depend on exogenous insulin to keep their blood glucose concentrations within the desired range. Subcutaneous bihormonal artificial pancreas devices that can measure glucose concentrations continuously and autonomously calculate and deliver insulin and glucagon infusions is a promising new treatment option for these patients. The slow absorption rate of insulin from subcutaneous tissue is perhaps the most important factor preventing the development of a fully automated artificial pancreas using subcutaneous insulin delivery. Subcutaneous insulin absorption is influenced by several factors, among which local subcutaneous blood flow is one of the most prominent. We have discovered that micro-doses of glucagon may cause a substantial increase in local subcutaneous blood flow. This paper discusses how the local vasodilative effects of micro-doses of glucagon might be utilised to improve the performance of subcutaneous bihormonal artificial pancreas devices. We map out the early stages of our hypothesis as a disruptive novel approach, where we propose to use glucagon as a vasodilator to accelerate the absorption of meal boluses of insulin, besides using it conventionally to treat hypoglycaemia.

Keywords: artificial pancreas; diabetes mellitus type 1; glucagon; pharmacokinctics; subcutaneous infusion.

Conflict of interest statement

The authors SMC and SCC are among the inventors of a pending patent application on the use of micro-doses of glucagon to enhance SC CGM performance and SC insulin absorption. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Copyright © 2022 Teigen, Riaz, Åm, Christiansen and Carlsen.

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