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The Effects of Repeated Daily Recombinant Human Insulin‐like Growth Factor I Administration in Adolescents with Type 1 Diabetes
Author(s) -
Cheetham T.D.,
Dunger D.B.,
Clayton K.,
Holly J.M.P.,
CwyfanHughes S.
Publication year - 1995
Publication title -
diabetic medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.474
H-Index - 145
eISSN - 1464-5491
pISSN - 0742-3071
DOI - 10.1111/j.1464-5491.1995.tb00391.x
Subject(s) - medicine , endocrinology , insulin , growth factor , diabetes mellitus , insulin like growth factor , recombinant dna , type 2 diabetes , hormone , biology , receptor , biochemistry , gene
Reduced insulin‐like growth factor bioactivity has been linked to poor metabolic control and growth hormone hypersecretion in adolescents with Type 1 diabetes. The safety and efficacy of recombinant human insulin‐like growth factor I administered subcutaneously in a dose of 40 μg kg −1 for 28 days was studied in a group of 6 adolescent male subjects with Type 1 diabetes (aged 13.6–19.4 years, puberty stage 3–5). After a 4‐week run‐in period (week 4 to day 0) recombinant human insulin‐like growth factor I was administered for 4 weeks (day 0 to week +4) before a run‐out of a further 4 weeks duration (week +4 to +8). HbA 1c levels were measured throughout the study and overnight profiles were undertaken to study levels of insulin‐like growth factor I, insulin‐like growth factor binding protein‐3, and growth hormone concentrations (week —1, day 0, and week +4). The injections were well tolerated and hypoglycaemia was not problematic at any stage of the study. Recombinant insulin‐like growth factor I administration appeared to lead to a sustained increase in insulin‐like growth factor I levels (week —1; 198 ± 16 ng ml −1 , week +4; 422 ± 18 ng ml −1 , mean ± SEM; p = 0.03). Insulin‐like growth factor binding protein‐3 concentrations ( n = 6) increased in 5 subjects (week —1; 4.5 ± 0.3 μg ml −1 , week +4; 5.1 ± 0.4 μg ml −1 ) and mean overnight growth hormone decreased (week −1; 14.0 ± 3.1 mU I −1 , week +4; 7.6 ± 1.7 mU I −1 ) during the period of study but these differences were not statistically significant. HbA 1c levels fell significantly at the time of rhIGF‐I administration (day 0; 10.4 ± 1.9% vs week +4; 9.4 ±1.9%; p = 0.03) despite a reduction in subcutaneous isophane insulin dose from 0.50 ± 0.02 U kg −1 to 0.41 ± 0.02 U kg −1 ( p = 0.03). There was no significant change in biochemical and haematological indices, glomerular filtration rate or urinary albumin excretion. The restoration of IGF‐I levels in adolescents with Type 1 diabetes may have a beneficial impact on glycaemic control.