The Challenge: Balancing Diabetes Control and Hypoglycemia Risk
High glucose increases long-term complications1, 2:
Low glucose increases short term hypoglycemia risk1, 2:
Sources:
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- http://www.nejm.org/doi/full/10.1056/NEJMoa1408214#t=article
- https://www.nejm.org/doi/full/10.1056/Nejmoa1003795
- Klonoff, et al. 2017
- Senior author Elizabeth Selvin, Ph.D., a professor of epidemiology at the Johns Hopkins Bloomberg School of Public Health in Baltimore, March, 2017
The Idea
A titratable, fixed-ratio combination of two well-understood and FDA approved peptides to control glycemia while mitigating the threat of hypoglycemia. A Smart solution that fits well with current and future pharmacological and device platforms.
Alan Cherrington PhD, a well respected researcher at Vanderbilt University, discovered that it is feasible to deliver insulin and glucagon together in a fixed concentration ratio. It is known that the actions of the two peptides are opposing: insulin lowers blood glucose while glucagon raises blood glucose (and is the foundation for emergency rescue from hypoglycemia). His discovery is founded on the observation that the actions of insulin and glucagon, when given together, are glucose dependent. The hormones act in concert for improved glycemic control and protection from hypoglycemia when co-administered at a critical concentration ratio.
The Medical Need
Insulin replacement therapy involves multiple daily insulin injections or the delivery of insulin by a pump, the need for careful blood glucose monitoring, and the fear of an unwanted fall in blood glucose (hypoglycemia). Fear of hypoglycemia prevents optimal glycemic management leading to long term hyperglycemia and damage to the body (kidney, heart, extremities).
The Promise
Patients who use the Abvance combination product, in place of insulin alone, will be able to experience improved blood glucose control with a safety buffer against hypoglycemia. This would not require some new behavioral change or device enablement, and will lighten the daily burden of their disease management.