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Item #11
Growth
Hormone Replacement Therapy Benefit Type 1’s
Growth
hormone (GH) replacement therapy is beneficial in patients with type 1
diabetes and GH deficiency.
That,
according to the results of a small study reported in the March issue
of Clinical Endocrinology.
"Specific
problems in patients with insulin-dependent diabetes mellitus (IDDM)
and GH deficiency are
hypoglycemic
attacks, increased insulin sensitivity, and loss of energy," Dr.
Emanuel R. Christ and colleagues from King's College London, UK, note.
These symptoms may be associated with GH deficiency.
The
researchers examined the effect of GH replacement therapy in five
diabetic patients with GH deficiency. The patients had a mean age of
41.6 years and mean BMI of 22.3. The team used validated
questionnaires to assess quality of life and measured body
composition, metabolic control (HbA1c), insulin requirements, and
frequency of hypoglycemia. In addition, they obtained monthly eye
photographs.
The
mean baseline insulin-like growth factor I (IGF-I) concentration was
7.8 nmol/L, which significantly increased 3 and 6 months (17.9 nmol/L
and 19.2 nmol/L, respectively; p < 0.05) after GH therapy.
Mean
baseline HbA1c levels was 8.2%, which did not change significantly
during the study.
Insulin
requirement at baseline was 0.40 U/kg per day. This increased
significantly (0.69 U/kg per day at 3 months and 7.0 U/kg per day at 6
months, p < 0.04) with GH replacement therapy.
After
6 months of GH replacement therapy, there was a nonsignificant
increase in lean body mass and a significant decrease in body fat mass
(p < 0.01).
The
results of monthly eye examinations showed no significant changes in
the retina in any of the patients.
"Number
of severe hypoglycemic (< 3 mmol/L) attacks decreased significantly
(p < 0.04) and quality of life assessed by validated questionnaires
improved significantly in all patients," Dr. Christ and
colleagues report.
These
findings suggest that, at least in the short-term, GH replacement
therapy can benefit type 1 diabetics with GH deficiency and that
long-term studies are warranted to determine the safety of this
treatment.
Clin
Endocrinol
2003;58:309-315.
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DO
YOU KNOW
Diabetes
Patients see their pharmacists 4 times a month on average. Make each
patient’s pharmacist a part of your diabetes care team and they can
help improve outcomes.
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