Effect of Diabetes and its Control on Insulin-like Growth Factors in the Young Subject with Type I Diabetes

Abstract

The influence of diabetes and its control on circulating levels of growth hormone and growth hormone-dependent, insulin-like growth factors (IGF) remains controversial. In the present study, the effect of a 1-wk period of intensive insulin therapy on growth hormone and IGF I and II has been determined in 19 young (age 13-22 yr), insulin-dependent (type I) subjects with diabetes mellitus. IGF I was low during conventional insulin therapy (198 +/- 20 versus 438 +/- 38 ng/ml in nondiabetic subjects, P less than 0.001), and rose within the week of intensified treatment (to 255 +/- 15 ng/ml, P less than 0.005), concomitant with a reduction in plasma glucose from 233 +/- 16 to 110 +/- 5 mg/dl. IGF I rose despite a significant fall in mean 24-h growth hormone levels from 14.1 +/- 2.2 to 9.0 +/- 1.2 ng/ml (P less than 0.02). The mean IGF II value for the diabetic subjects (504 +/- 39 ng/ml) was not significantly different from that of the nondiabetic control group (506 +/- 30 ng/ml, P greater than 0.3) and was not altered by intensified therapy. However, four individual patients with very low IGF I also had depressed IGF II (248 +/- 16 ng/ml), which was corrected (to 377 +/- 35 ng/ml) with improved metabolic control. These data suggest that elevated growth hormone levels in poorly controlled diabetes are ineffective in IGF I generation and that this defect is at least partially corrected by acute improvement in control. The rise in IGF I levels accompanying intensive insulin treatment may suppress the excessive secretion of growth hormone.(ABSTRACT TRUNCATED AT 250 WORDS)

Growth in patients with type 1 diabetes

“…Altered IGF1 and binding protein concentrations are thus thought to be secondary to decreased portal vein insulin concentration given that therapeutic administration of insulin in diabetes is via the subcutaneous route. Administration of insulin or intensification of therapy improves but does not normalize these abnormalities 45-47 . Indirect evidence for the importance of portal insulin was provided by Hedman and colleagues who demonstrated that residual β-cell function was associated with higher IGF1 and lower IGFBP1 concentrations independent of glycemic control 48 .…”

Diabetes and Bone Marrow Adiposity

“…Diabetes results in alterations to the GH axis. Adolescents with T1DM have been shown to have low IGF-1 levels despite GH elevations [54, 55]. Effects of T2DM on the GH axis are less clear, although obesity—often accompanying T2DM—is thought to blunt the axis [56].…”

Menarcheal age of type 1 diabetic Bengali Indian females

“…Metabolic control in patients with T1DM is often impaired during puberty and adolescence, a phenomenon that has been ascribed to increased growth hormone secretion [4,5]. Girls with T1DM display poorer glycemic control than boys with the same disease [6][7][8][9].…”