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 < 0.001), and rose within the week of intensified treatment (to 255 ±15 ng/ml, P < 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 < 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 > 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. IGF II levels appear to be affected only by the most severe reductions of growth hormone activity.
Effect of Diabetes and its Control on Insulin-like Growth Factors in the Young Subject with Type I Diabetes
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Stephanie A Amiel, Robert S Sherwin, Raymond L Hintz, Joseph M Gertner, C Martin Press, William V Tamborlane; Effect of Diabetes and its Control on Insulin-like Growth Factors in the Young Subject with Type I Diabetes. Diabetes 1 December 1984; 33 (12): 1175–1179. https://doi.org/10.2337/diab.33.12.1175
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