Treatment of symptoms of neuroglycopenia with Glucose Rapid-Spray (TM) to avoid rebound hyperglycaemia

The correction of symptoms of neuroglycopenia occurring in hyperinsulinemic insulin resistant subjects using unrestricted amount of carbohydrates may cause rebound hyperglycaemia which induces a chain reaction leading to an increase in insulin secretion, thus perpetuating the state of insulin resistance. For a better approach to manage symptoms of neuroglycopenia, a slight increase of blood glucose levels without stimulating a significant endogenous insulin release may be more suitable.The aim of this study was to evaluate changes of plasma glucose and insulin levels following the administration of small amounts of glucose through the Glucose Rapid SprayTM (GRS) device. With this device glucose is sprayed into the mouth and is rapidly absorbed through the buccal mucosa. We studied 8 healthy volunteers, mean age 26 ± 3 years. Plasma glucose and insulin levels were determined at 0, 5, 15 and 30 minutes following 10 oral puffs (~ 0.5 g) of GRS.Five minutes after puffs administration there was a mean glucose increase of 6.1±1.0 % (P<0.0001) compared to basal conditions. The mean increasing was 3.2±1.0 % and 1.8±1.0% after 15 and 30 minutes, respectively (P= NS). Insulin levels did not change significantly after 10 puffs GRS administration.The results of this preliminary study indicate that the administration of glucose by GRS in quantity of ~ 0.5 g is able to slightly increase blood glucose levels without stimulating endogenous insulin release. The fine tuning of blood glucose with GRS using a number of puffs varying between 10 and 20, as required, may prove to be effective in managing signs of neuroglycopenia which precede hypoglycaemia, thus favouring the disappearance of symptoms which stimulate an intake of uncontrolled amount of carbohydrates.