Efficacy of sandostatin LAR in type 1 DM; improvement in glycemic control with less insulin. a case report

Abstract

Objective: Octreotide three times daily is reported to reduce daily insulin by 50% in patients with Type 1 DM. Therefore, we assessed the impact of long acting Octreotide (Sandostatin LAR) monthly intramuscular administration in a subject with Type 1 DM. Methods: A 32-year-old man with Type 1 DM of 16 years participated after obtaining informed consent. He had no microvascular or macrovascular complications. He continued the present insulin regimen for four weeks. IM Sandostatin LAR 20 mg was initiated and increased at four weeks to 30 mg. He was followed every four weeks for six months. Insulin regimen was adjusted every one to two weeks based on blood glucose before meals, bedtime and on onset of hypoglycemic symptoms. He continued other medications, previous diet and activity. Assessment of HbA1c, serum electrolytes, urea nitrogen, creatinine, TSH, free T4, liver enzymes, complete blood cell counts, vitamin B12, lipids and insulin regimen were performed at the initiation and end of the study. Results: HbA1c declined from 9 to 8% with reduction in daily insulin dose from 55 to 43 units, with a major reduction in insulin Glargine, 50 to 40 units. Body weight remained unaltered. Other laboratory tests including gallbladder examination remained unchanged Conclusion: Monthly Sandostatin LAR administration may improve glycemic control with less insulin in Type 1 DM.