Puffing Glucagon Up Your Nose

[compound26]

This is so similar in concept to Afrezza.  Note that it is also in dry power.

"You'll just stick the tube into a nostril and press the bottom, making the dry powder glucagon shoot into your nose where it's absorbed into the system. It's kind of like Flonase spray, except it's dry and not a mist."

[sayhey24]

I wonder how big Lilly thinks this market is? The molecular weight for glucagon is 3485 daltons and would probably work pretty well with Technosphere. I think I would rather inhale than blow up my nose and have all the sneezing. Maybe Dr. Kendall needs to call some of his old mates.

However, if all the PWDs were using afrezza the market would be even smaller

[agedhippie]

Jul 24, 2018 19:19:38 GMT -5 sayhey24 said:

I wonder how big Lilly thinks this market is? The molecular weight for glucagon is 3485 daltons and would probably work pretty well with Technosphere. I think I would rather inhale than blow up my nose and have all the sneezing. Maybe Dr. Kendall needs to call some of his old mates.

However, if all the PWDs were using afrezza the market would be even smaller

The market for this reasonably large. All EMTs and Type 1s are meant to carry glucagon kits and your endo usually insists on prescribing one. The problem is that the only glucagon kit on the market (also made by Lilly) is notoriously tricky to use and is best left for an EMT (if you want to see it's here - www.lillyglucagon.com/). You take the syringe preloaded with saline and inject the liquid into the vial of powdered glucagon. Mix until dissolved and then draw the liquid back into the syringe and inject into a muscle (the butt is good). Now stand back because they are likely to throw up from the glucagon.

It really is best left for the EMT, the success rate for the general public is abysmally low. A powder you can squirt up somebody's nose is a huge improvement and that should help a lot. I thought at one point it was something Mannkind should look at, but on a moment's reflection I realized the inhale would be impossible. You do not give someone glucagon unless they are unconscious, instead you use glucose either in tablet or liquid, or as a gel if they cannot swallow. Glucagon in the quantity to make you recover from unconsciousness is a pretty unpleasant experience, you will feel awful and be throwing up a lot.

There is the Zealand liquid glucagon analog as well. The Lilly glucagon kit is expensive and expires.

[xanet]

Jul 24, 2018 20:07:34 GMT -5 agedhippie said:

Jul 24, 2018 19:19:38 GMT -5 sayhey24 said:

I wonder how big Lilly thinks this market is? The molecular weight for glucagon is 3485 daltons and would probably work pretty well with Technosphere. I think I would rather inhale than blow up my nose and have all the sneezing. Maybe Dr. Kendall needs to call some of his old mates.

However, if all the PWDs were using afrezza the market would be even smaller

The market for this reasonably large. All EMTs and Type 1s are meant to carry glucagon kits and your endo usually insists on prescribing one. The problem is that the only glucagon kit on the market (also made by Lilly) is notoriously tricky to use and is best left for an EMT (if you want to see it's here - www.lillyglucagon.com/). You take the syringe preloaded with saline and inject the liquid into the vial of powdered glucagon. Mix until dissolved and then draw the liquid back into the syringe and inject into a muscle (the butt is good). Now stand back because they are likely to throw up from the glucagon.

It really is best left for the EMT, the success rate for the general public is abysmally low. A powder you can squirt up somebody's nose is a huge improvement and that should help a lot. I thought at one point it was something Mannkind should look at, but on a moment's reflection I realized the inhale would be impossible. You do not give someone glucagon unless they are unconscious, instead you use glucose either in tablet or liquid, or as a gel if they cannot swallow. Glucagon in the quantity to make you recover from unconsciousness is a pretty unpleasant experience, you will feel awful and be throwing up a lot.

There is the Zealand liquid glucagon analog as well. The Lilly glucagon kit is expensive and expires.

[Speaking as an EMT in my former life]: In my state, we only administer glucagon if we can't start an IV.  We use dextrose, 25 gm.

[agedhippie]

Jul 24, 2018 23:09:38 GMT -5 xanet said:

Jul 24, 2018 20:07:34 GMT -5 agedhippie said:

The market for this reasonably large. All EMTs and Type 1s are meant to carry glucagon kits and your endo usually insists on prescribing one. The problem is that the only glucagon kit on the market (also made by Lilly) is notoriously tricky to use and is best left for an EMT (if you want to see it's here - www.lillyglucagon.com/). You take the syringe preloaded with saline and inject the liquid into the vial of powdered glucagon. Mix until dissolved and then draw the liquid back into the syringe and inject into a muscle (the butt is good). Now stand back because they are likely to throw up from the glucagon.

It really is best left for the EMT, the success rate for the general public is abysmally low. A powder you can squirt up somebody's nose is a huge improvement and that should help a lot. I thought at one point it was something Mannkind should look at, but on a moment's reflection I realized the inhale would be impossible. You do not give someone glucagon unless they are unconscious, instead you use glucose either in tablet or liquid, or as a gel if they cannot swallow. Glucagon in the quantity to make you recover from unconsciousness is a pretty unpleasant experience, you will feel awful and be throwing up a lot.

There is the Zealand liquid glucagon analog as well. The Lilly glucagon kit is expensive and expires.

[Speaking as an EMT in my former life]: In my state, we only administer glucagon if we can't start an IV.  We use dextrose, 25 gm.

That would make sense. You really don't want to give people a glucagon shot unless you have to. In rescue quantities glucagon is not a pleasant experience.

[compound26]

Also note that since this technology was purchased by Lily in 2015, presumably such purchase was okay-ed by none other than our current CMO, Dr. Kendall.  Dr Kendall must did some home work on dry power + inhalation delivery technology and market at that time.  And he must have foreseen a pretty bright future in dry power + inhalation delivery technology and market for him to okay the purchase. 

So, he already had part of his home work done long before he took the offer from Mannkind in Feb. 2018.

[mango]

Maybe glucagon is the Undisclosed molecule moving forward.

Glucagon is in Bucket 2.

[brotherm1]

What’s it doing in our bucket if patients that need it are allegedly unconscious?

[mango]

Jan 7, 2019 21:44:51 GMT -5 brotherm1 said:

What’s it doing in our bucket if patients that need it are allegedly unconscious?

Being conscious is not a contraindication. 

In a recent Phase 3 clinical trial by Eli Lilly 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, nasal inhaled glucagon was indeed administered to conscious humans. 

"The present study was designed to further evaluate the effectiveness of 3 mg of NG while being administered by caregivers in the pediatric population with T1D for the treatment of hypoglycemia in a real‐world setting. Since the incidence of severe hypoglycemia in children is relatively low, symptomatic moderate hypoglycemic events were also included as surrogates of severe hypoglycemia."

"Although 3 patients discontinued the study due to severe nasal discomfort, this may have less clinical significance since NG will be used as a rescue medication for patients with severe hypoglycemia, which is often associated with loss of consciousness or seizures."

Does Eli Lilly's nasal inhalation delivery system administer precise doses?
Administering glucagon using an oral inhalation delivery system by MannKind Corporation allows for precise doses of glucagon to be delivered.