How Does Zegalogue Work to Reverse Severe Hypoglycemia?

October 6, 2025 •

2 min read

According to clinical trial data, Zegalogue (dasiglucagon) can raise blood glucose levels and resolve severe hypoglycemia in many patients within 10 to 15 minutes. This injectable medication is an analog of the naturally occurring hormone glucagon and provides a fast-acting, ready-to-use solution for diabetes-related emergencies.

Quick Summary

Zegalogue, containing the active ingredient dasiglucagon, functions as a glucagon receptor agonist to treat severe hypoglycemia. It works by stimulating the liver to release stored glucose, rapidly increasing blood sugar levels. Available as a premixed autoinjector or prefilled syringe, it offers a more convenient rescue option than traditional glucagon kits.

Key Points

Dasiglucagon is the Active Ingredient: The medication contains dasiglucagon, a synthetic version of the natural hormone glucagon.
Glucagon Receptor Agonist: Zegalogue works by binding to glucagon receptors in the liver, mimicking the natural hormone's action.
Stimulates Glycogenolysis: It rapidly increases blood sugar by stimulating the liver to break down stored glycogen into glucose.
Easy, Ready-to-Use Injection: Unlike traditional glucagon kits, Zegalogue is a premixed, ready-to-inject solution available in an autoinjector or prefilled syringe.
Quick Recovery Time: Clinical studies show that it can raise blood glucose levels and resolve severe hypoglycemia in many patients within 10 to 15 minutes.
Contingent on Glycogen Stores: The medication is only effective if the liver has enough glycogen stores to release; it will not work for patients in a state of starvation.
Contraindicated in Certain Conditions: It should not be used in patients with pheochromocytoma or insulinoma due to the risk of dangerous side effects.

The Mechanism of Action: Mimicking Natural Glucagon

Zegalogue's active ingredient is dasiglucagon, a synthetic analog of the hormone glucagon naturally produced by the pancreas. Its primary function is to restore blood glucose levels during a severe hypoglycemic event by mimicking the action of natural glucagon. Zegalogue is classified as a glucagon receptor agonist and an antihypoglycemic agent. It triggers the body's glucose production mechanisms, but its effectiveness depends on adequate glycogen stores in the liver.

The Role of Glucagon Receptors

Dasiglucagon works by binding to and activating glucagon receptors, mainly located in the liver. This interaction initiates a cellular signaling pathway that involves activating adenylate cyclase and increasing intracellular cyclic AMP (cAMP) levels.

Stimulating Glycogenolysis and Gluconeogenesis

The increased cAMP levels in liver cells stimulate two key processes that raise blood glucose:

Glycogenolysis: The breakdown of stored glycogen in the liver into glucose, providing a rapid increase in blood sugar.
Gluconeogenesis: The creation of new glucose from non-carbohydrate sources, offering a more sustained effect to help prevent further hypoglycemia.

Prerequisites for Efficacy

Zegalogue requires sufficient liver glycogen stores to be effective. It may not work in individuals with depleted glycogen due to conditions like prolonged fasting or adrenal insufficiency. If Zegalogue is not effective, intravenous glucose is the appropriate treatment.

Zegalogue vs. Traditional Glucagon: A Ready-to-Use Approach

Zegalogue offers a user-friendly, ready-to-use format that is beneficial during emergencies compared to older glucagon products. A comparison of features includes:


Feature	Zegalogue (dasiglucagon)	Traditional Glucagon (e.g., GlucaGen)
Formulation	Premixed, ready-to-use liquid solution	Powder vial that must be mixed with sterile water before injection
Preparation	No mixing required	Requires a multi-step mixing process
Device	Single-dose autoinjector or prefilled syringe	Traditional vial and syringe kit
Speed	Often achieves recovery within 10-15 minutes in clinical trials	Recovery can take longer due to preparation steps
Administration	Subcutaneous injection	Can be administered intramuscularly

Administration and Patient Guidelines

Zegalogue is administered as a subcutaneous injection in areas like the lower abdomen, buttocks, thigh, or outer upper arm. In case of severe hypoglycemia, administer the injection immediately, call for emergency help, and provide the patient with fast-acting sugar and a meal once able to swallow. Monitor blood sugar levels for several hours.

Important Warnings and Contraindications

Zegalogue is contraindicated in patients with pheochromocytoma or insulinoma due to potential risks. Allergic reactions are possible. The medication requires sufficient liver glycogen stores and may not be effective in individuals with depleted stores.

Conclusion: A Simplified Solution for a Critical Emergency

Zegalogue provides a ready-to-use solution for managing severe hypoglycemia. Its mechanism as a glucagon receptor agonist effectively raises blood sugar. The prefilled autoinjector or syringe offers a simpler and quicker alternative to older kits, improving emergency response.

Frequently Asked Questions

Severe hypoglycemia is a state of very low blood sugar, typically below 54 mg/dL, that requires assistance from another person to treat because the affected individual may be unable to eat, drink, or self-treat effectively.

In clinical trials, Zegalogue was shown to be effective at raising blood glucose levels and achieving recovery in many patients within 10 to 15 minutes of administration.

The main difference is that Zegalogue comes as a ready-to-use, premixed liquid in an autoinjector or prefilled syringe, eliminating the need to mix powder and liquid during an emergency.

Zegalogue is administered as a subcutaneous injection into the lower abdomen, buttocks, thigh, or outer upper arm.

The most common side effects reported in clinical trials include nausea, vomiting, headache, diarrhea, and injection site pain.

Immediately call for emergency medical assistance. Once the person is alert and able to swallow, give them a source of fast-acting carbohydrates followed by a long-acting snack or meal.

Zegalogue is indicated for the treatment of severe hypoglycemia in pediatric patients aged 6 years and older. It has not been evaluated for safety and effectiveness in children under 6.