Glucagon analog · hypoglycemia rescue
Dasiglucagon is a 29-amino-acid analog of glucagon, the hormone that tells the liver to release stored sugar. Traditional glucagon emergency kits are mixed from powder; dasiglucagon stays dissolved and stable in a water-based liquid, so it comes ready to inject as an emergency treatment for severe low blood sugar in people with diabetes4,5.
Dasiglucagon activates glucagon receptors in the liver, which breaks down stored glycogen and releases glucose into the blood4. Because it depends on those glycogen stores, it may not work in people who are starving, have adrenal insufficiency or have long-standing low blood sugar; they need glucose instead4. Its amino-acid sequence differs from native glucagon in ways that keep it dissolved and stable in water, which is what allows a premixed autoinjector or syringe5. In studies of insulin-induced hypoglycemia, blood sugar rose meaningfully within about ten minutes, comparable to reconstituted glucagon1,5.
Human trials in type 1 diabetes led to approval. In a double-blind trial of 170 adults whose blood sugar was lowered with insulin, median time to glucose recovery was 10 minutes with dasiglucagon versus 40 with placebo, and 99% recovered within 15 minutes1.
A matching trial in 42 children and adolescents aged 6 to 17 found 10 versus 30 minutes2. In 2026 the label replaced its pediatric age limit with a minimum body weight, supported by that trial plus pharmacokinetic and side-effect data from an open-label study in children under six4. Separately, an open-label phase 3 trial gave continuous infusion to 32 children with congenital hyperinsulinism: the main fingerstick endpoint was not met, though post hoc sensor data showed less hypoglycemia3. That use is not on the US label4.
FDA-approved in March 2021 as Zegalogue for severe hypoglycemia in people with diabetes; a June 2026 update set the pediatric limit by body weight rather than age4,6. Drugs@FDA currently lists both Zegalogue presentations as discontinued6.
In trials, nausea and vomiting were the most frequent effects, as with glucagon; headache, diarrhea and injection-site pain also occurred1,4. It must not be used in people with pheochromocytoma, where it can trigger a sharp rise in blood pressure, or insulinoma, where it can provoke later hypoglycemia. Allergic reactions, including anaphylaxis, have been reported with glucagon products. Beta-blockers, indomethacin and warfarin can interact with it4.
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