Low-Dose Glucagon to Prevent and Treat Exercise-Associated Hypoglycemia in Individuals With Type 1 Diabetes: A Systematic Review and Meta-analysis
Authors' conclusion
Low-dose glucagon reduces exercise-induced hypoglycemia and TBR in T1D individuals. Future research should optimize glucagon dosage and timing for various exercise types and durations to confirm real-world effectiveness.
Study context
- Population
- Adolescents and adults with T1D in controlled exercise settings; mean age 36 ± 10.5 years; searches to September 2024
- Participants
- 248 adolescents12 studies
- Comparison
- Low-dose glucagon vs nonglucagon treatments
- Outcome
- Hypoglycemia and TBR (glucose <3.9 mmol/L)
Methodological detailsRCTs and crossover studies, random effects model, Risk of Bias-2 and GRADE assessment, sensitivity analysis informed by Risk of Bias 2, Included studies were few and heterogeneous, which may have influenced the overall outcomes
- RCTs and crossover studies
- Random effects model
- Risk of Bias-2 and GRADE assessment
- Sensitivity analysis informed by Risk of Bias 2
- Included studies were few and heterogeneous, which may have influenced the overall outcomes
Pooled result
As reported in the abstract
Low-dose glucagon vs Nonglucagon treatmentsRelative risk (95% CI)
Hypoglycemia risk
0.54(0.35–0.84)
Low-dose glucagon vs Nonglucagon treatmentsDifference, percentage points (95% CI)
TBR
−3.91(−6.27 to 1.54)
Safety
| Outcome | RR (95% CI) | |
|---|---|---|
| Overall adverse events | 2.75 (1.07–7.08) | |
| 0.10.31310Relative risk (log scale) |
Original publication
Low-Dose Glucagon to Prevent and Treat Exercise-Associated Hypoglycemia in Individuals With Type 1 Diabetes: A Systematic Review and Meta-analysis. Diabetes Care. Published 20 August 2025. doi:10.
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