Recombinant human insulin-like growth factor-I therapy improves glycemic control and insulin action in the type A syndrome of severe insulin resistance.

• DOI: 10.1210/jcem.79.1.8027228
• Publication Date: 2014-01-08T16:58:30Z
• Authors: L A Morrow; M B O'Brien; D E Moller; J S Flier; A C Moses
• Keywords: Insulin tolerance test; Glucose tolerance test; Bolus (digestion)

Recombinant human (rh) insulin-like growth factor-I (IGF-I) is a potential therapy for individuals with severe insulin resistance, but its efficacy, mechanism of action, or duration effect these patients have not been explored fully. Two subjects the type A phenotype resistance without receptor mutations were investigated to assess secretion, and carbohydrate tolerance before after 3-4 weeks rhIGF-I treatment (100 micrograms/kg, sc, twice daily). Tests included 24-h glucose profile (modal day), standardized liquid meal Sustacal, test, suppression iv test. In subject 1, mean blood level was 8.1 +/- 2.7 mmol/L fell 4.2 0.9 during treatment. The pretreatment serum 10,251 8,849 pmol/L 1533 1198 pmol/L. Fasting from 4.4 3.4 mmol/L, 2-h Sustacal administration 10.3 5.3 mmol/L. declined 808 246 pmol/L, 5,491 3,443 After bolus injection (0.15 U/kg), by 20% 67% steady state plasma 18.2 0.7 10.8 0.1 rhIGF-I. 2, fasting 12.0 7.4 12.7 1.9 6.6 1.3 Twenty-four-hour 892 635 521 293 first phase secretion restored We conclude that sc can reduce effectively in selected who diabetes mellitus. also enhance sensitivity, as assessed decrease endogenous levels, normalization response insulin, reduced glucose. cellular mechanisms effects remain undefined.