Which medications in the drug class Glucose-Elevating Agents are used in the treatment of Hypoglycemia?

Updated: Jul 23, 2020
  • Author: Osama Hamdy, MD, PhD; Chief Editor: Romesh Khardori, MD, PhD, FACP  more...
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Glucose-Elevating Agents

Glucose-elevating agents can act in the pancreas or the peripheral tissues to increase blood glucose levels.

Glucagon (GlucaGen, Gvoke)

Pancreatic alpha cells of islets of Langerhans produce glucagon, a polypeptide hormone. This agent exerts effects opposite of insulin on blood glucose and elevates blood glucose levels by inhibiting glycogen synthesis and enhancing formation of glucose from noncarbohydrate sources, such as proteins and fats (gluconeogenesis).

Glucagon also increases hydrolysis of glycogen to glucose (glycogenolysis) in the liver. This agent accelerates hepatic glycogenolysis and lipolysis in adipose tissue by stimulating cyclic AMP (cAMP) synthesis via adenylyl cyclase and enhancing phosphorylase kinase activity.

Glucagon may be useful when intravenous (IV) access for dextrose administration is problematic. This agent may be administered as part of emergency medical services (EMS) protocol in patients with altered mental status and no IV access. It is also available as a ready-to-use subcutaneous (SC) solution in prefilled syringes or an autoinjector.

Glucagon intranasal (Baqsimi)

This agent activates hepatic glucagon receptors, which stimulate cyclic adenosine monophosphate (cAMP) synthesis. Hepatic glycogenolysis and gluconeogenesis are thus accelerated, with blood glucose levels consequently increasing. Glucagon requires preexisting hepatic glycogen stores to effectively treat hypoglycemia. Glucagon intranasal is indicated for severe hypoglycemic reactions in adults and children (aged 4 years or older) with diabetes.

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