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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. ================================ 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.