Normalization of the IGF-IGFBP Axis by Sustained Nightly Insulinization in Type 1 Diabetes  

Oleh:

Ekström, Klas ; Salemyr, Jenny ; Zachrisson, Ingmar ; Carlsson-Skwirut, Christine ; Örtqvist, Eva ; Bang, Peter

Jenis: Article from Journal - ilmiah internasional
Dalam koleksi: Diabetes Care vol. 30 no. 06 (Jun. 2007), page 1357.
Topik: Clinical Care; Education; Nutrition

Ketersediaan

Perpustakaan FK Nomor Panggil: D05.K.2007.02 Non-tandon: 1 (dapat dipinjam: 0) Tandon: tidak ada

Lihat Detail Induk

Isi artikel

OBJECTIVE—We sought to test the hypothesis that start of insulin glargine with sustained nightly insulin action results in changes in circulating concentrations of IGF-I and IGF binding proteins (IGFBPs) in adolescents with type 1 diabetes—changes that may support improvement of A1C. RESEARCH DESIGN AND METHODS—Twelve pubertal adolescents with type 1 diabetes and initially on NPH insulin were studied during 12 weeks of intensified treatment with glargine. RESULTS—Subnormal IGF-I SD scores on NPH (–1.8 ± 0.4) rapidly increased and remained 54 ± 9% elevated (P < 0.001) after 12 weeks on glargine. A1C decreased from 8.3 ± 0.6% to a nadir of 6.9 ± 0.3% (P = 0.002) at 6 weeks and correlated with changes in IGF-I (r = –0.64, P < 0.05). The increase in IGF-I did not suppress the mean overnight growth hormone (GH) secretion at 6 weeks. The mean overnight IGFBP-1 levels decreased (P = 0.035), supporting the hypothesis that the nightly hepatic insulin action was increased. Circulating IGF-I increased in the absence of changes in both GH secretion and GH receptor numbers (assessed by growth hormone binding protein), indicating that postreceptor mechanisms are involved. IGFBP-3 proteolysis was decreased. CONCLUSIONS—Increased hepatic insulin action after start of glargine was evident from a decrease in night time IGFBP-1 concentrations. This may improve GH postreceptor signaling, resulting in increased circulating IGF-I. We suggest that even in the absence of changes in GH, increased IGF-I and decreased IGFBP-1 support the improvement of metabolic control.

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