How a Drug that Blocks Glucagon Might

Help People With Type 1 Diabetes

Photo by Adobe Stock Photos

By Sysy Morales
July 4th, 2017

A new study testing a glucagon-blocking drug finds that it may help those with type 1
diabetes require less insulin and improve blood sugar levels.

This information was recently presented at the American Diabetes Associations 77th
Scientific Sessions at the San Diego Convention Center in San Diego, California.

A PRNewswire press release states that just one dose of REMD-477 can substantially lower
the amount of insulin required as well as help improve blood sugar levels without increasing
hypoglycemia in people with type 1 diabetes.

REMD-477 is a Human Glucagon Receptor (GCGR) Antibody.

Glucagon is the hormone created in the pancreas in response to a low blood sugar. Glucagon
causes the liver to break down glycogen so that it is converted into glucose in the blood or
creating glucose from amino acids through a process called gluconeogenesis.
Ideally, blood sugar is tightly regulated by insulin and glucagon. In individuals with
diabetes, glucagon effects may not be appropriately balanced by insulin, resulting in elevated
blood glucose, states the press release.

Testing a Glucagon-Blocking Drug in Type 1 Diabetes

This study was double-blind, randomized, and placebo-controlled with 21 adult participants,
8 men and 13 women all with type 1 diabetes. First, participants glucose levels were
measured using a Continuous Glucose Monitor (CGM) and then they were admitted for an
in-patient observation period of 5 days. During this time they all received the same meals and
a continuous IV insulin infusion to help manage blood sugar levels.

The press release states that On the second day of observation, 10 patients received a single
70 milligram (mg) subcutaneous injection of the glucagon-blocking drug, REMD-477a
fully human antibody that specifically binds to and blocks glucagon receptor signaling for the
treatment of metabolic disorders, including [type 1 diabetes]. The other 11 patients just got a
placebo injection.

The researchers explain that REMD-477 was found using Xenomouse technology, which
recapitulates a human antibody response in the mouse, and the antibody sequences are fully
human,

They compared the insulin needs and glucose levels of the patients who got the REMD-477
injection and compared them on day one versus day four of observation to the placebo
receiving participants.

Reduced Inulin Use and Improved Blood Glucose Management

The researchers report that the results show those who received the REMD-477 injection
lowered their daily insulin use by 26 percent (12 units) compared to those who got the
placebo.

Patients then had the CGMs connected for 8 weeks after the inpatient observation and
researchers found that the average daily blood sugar levels according to the CGM was 20 to
31 mg/dL lower in the REMD-477 participants than in the placebo participants during the 3
weeks after the inpatient observation.

Not only were blood sugar levels improved but low blood sugar was not increased for the
REMD-477 patients. According to their observation of the REMD-477 and the length of time
it lasted seen by persistent blood concentrations, researchers say it is possible patients could
receive one dose per week.

Dr. Jeremy Pettus, this studys lead author and an assistant professor of medicine in the
endocrinology department at the University of California, San Diego said, Our study
strongly supports the long-held theory that blocking glucagon may have a significant clinical
impact on care for people with type 1 diabetes by improving glucose levels and lowering
insulin doses, and that We expected that the drug [REMD-477] would have an effect, yet
the degree to which the drug reduced the need for insulin and improved patients blood sugar
levels without increasing hypoglycemia events was a surprise.
A follow-up study will take place and this time focus on treating patients over a longer length
of time as well as compare weekly injections at two different dosage levels in order to get a
better idea of how this drug might affect blood sugar levels, insulin requirements, and their
weight as outpatients.

Read more about American Diabetes Association (ADA), glucagon, insulin, low blood sugar,
type 1 diabetes study.

Last Updated: July 2nd, 2017

Filed Under: News, Treatments, Type 1 Diabetes
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Sysy Morales

Sysy Morales has lived with type 1 diabetes for 22 years. She also blogs at The Girls Guide
to Diabetes, is a motivational speaker, and is a graduate of The Institute for Integrative
Nutrition. Sysy lives in Roanoke, Virginia with her husband and 8 year old twins.