Novel Application of Microdosing Glucagon for Hypoglycemia After Total Pancreatectomy and Autologous Islet Transplant

Total pancreatectomy and autologous islet transplantation (TPAIT) is a procedure to ameliorate dysglycemia associated with post-pancreatectomy. Patients who undergo TPAIT are at risk of developing hypoglycemia postoperatively. The current literature suggests that hypoglycemia may be due to a glucagon-deficiency state. To date, there is minimal literature available that explores treatment options to minimize hypoglycemia in these patients. In this case, a 29-year-old female patient was administered a microdosing glucagon protocol post TPAIT and experienced improvements in hypoglycemia. We describe the dosing regimen of the protocol and provide continuous glucose monitoring data to support our findings. This case adds to the limited evidence on effective treatment options for these rare patients. To our knowledge, this is the first application of a microdosing glucagon protocol to treat hypoglycemia associated with TPAIT.