Elevated serum growth hormone in a patient with Type 1 diabetes: a diagnostic dilemma

Herlihy, O M; Perros, Petros

doi:10.1002/1520-7560(200005/06)16:3<211::aid-dmrr118>3.0.co;2-s

Cited by 18 publications

(4 citation statements)

References 38 publications

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“…The increased concentrations of growth hormone are thought to be due to the reduction in the negative feedback inhibition by the low levels of IGF-1.Gr owth hormone induces insulin resistance, and high circulating concentrations of the hormone may therefore make diabetic control more difficult. In addition to these negative metabolic effects, high concentrations of growth hormone may cause a diagnostic dilemma when hypersomatotropism is suspected in diabetic individuals (Herlihy and Perros 2000). The concentrations of growth hormone in people with type 2 diabetes mellitus seem to depend on a variety of factors and may be high, low or normal (Bang andothers 1994, MacFarlane 1997).…”

Section: Discussionmentioning

confidence: 99%

Measurements of growth hormone and insulin‐like growth factor 1 in cats with diabetes mellitus

et al. 2006

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Serum concentrations of insulin-like growth factor 1 (IGF-1) and growth hormone were measured in 25 cats with untreated diabetes mellitus (11 of which were used for follow-up measurements, one to three, four to eight, nine to 12 and 13 to 16 weeks after their treatment with insulin began), 14 diabetic cats that had previously been treated with insulin, and seven diabetic cats that also had hypersomatotropism, two of which had not previously been treated with insulin; 18 healthy cats were used as controls. In the untreated diabetic cats the concentration of IGF-1 ranged from 13.0 to 433.0 ng/ml (median 170.5 ng/ml), which was significantly lower than the concentrations in the control cats (196.0 to 791.0 ng/ml, median 452.0 ng/ml). Their IGF-1 concentrations increased significantly when they were treated with insulin and after four to eight weeks were not different from those in the control cats. In the diabetic cats that had previously been treated with insulin the IGF-1 concentrations were 33.0 to 476.0 ng/ml (median 316.0 ng/ml), which was significantly lower than the concentrations in the control cats, but significantly higher than in the untreated diabetic cats. The IGF-1 concentrations in the two previously untreated diabetic cats with hypersomatotropism were low and low-normal but increased markedly after treatment with insulin. In the five previously treated cats with hypersomatotropism the concentration of IGF-1 was above the normal range. The concentrations of growth hormone in the treated and untreated diabetic cats without hypersomatotropisms were not significantly different and there was an overlap in its concentrations in the diabetic cats with and without hypersomatotropism.

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Section: Discussionmentioning

confidence: 99%

Measurements of growth hormone and insulin‐like growth factor 1 in cats with diabetes mellitus

et al. 2006

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“…Insulin deficiency in type I DM also results with a decrease in IGF-1 levels [21][22][23], because an adequate amount of insulin is required for the expression of GH receptors on hepatocytes. In the absence of insulin, serum GH levels increase because of reduced hepatic GH receptors and so revealing a hepatic GH resistance and lower IGF-1 synthesis [45,46]. It is known that hepatic insulin resistance is associated with de- creased IGF-1 levels in non-acromegalic patients and this is also considered as a predictor for possible future glucose intolerance [47,48].…”

Section: Discussionmentioning

confidence: 99%

Impact of Glucose Metabolism Disorders on IGF-1 Levels in Patients with Acromegaly

et al. 2018

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In this study, we aimed to evaluate the presence of glucose metabolism abnormalities and their impact on IGF-1 levels in patients with acromegaly. Ninety-three patients with acromegaly (n=93; 52 males/41 females) were included in this study. Patients were separated into three groups such as; normal glucose tolerance (n=23, 25%), prediabetes (n=38, 41%), and diabetes mellitus (n=32, 34%). Insulin resistance was calculated with homeostasis model assessment (HOMA). HOMA-IR > 2.5 or ≤2.5 were defined as insulin resistant or noninsulin resistant groups, respectively. Groups were compared in terms of factors that may be associated with glucose metabolism abnormalities. IGF-1% ULN (upper limit of normal)/GH ratios were used to evaluate the impact of glucose metabolism abnormalities on IGF-1 levels. Patients with diabetes mellitus were significantly older with an increased frequency of hypertension (p<0.001, p=0.01, respectively). IGF-1% ULN/GH ratio was significantly lower in prediabetes group than in normal glucose tolerance group (p=0.04). Similarly IGF-1% ULN/GH ratio was significantly lower in insulin resistant group than in noninsulin resistant group (p=0.04). Baseline and suppressed GH levels were significantly higher in insulin resistant group than in noninsulin resistant group (p=0.024, p<0.001, respectively). IGF-1% ULN/GH ratio is a useful marker indicating glucose metabolism disorders and IGF-1 levels might be inappropriately lower in acromegalic patients with insulin resistance or prediabetes. We suggest that IGF-1 levels should be re-evaluated after the improvement of insulin resistance or glycemic regulation for the successful management of patients with acromegaly.

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“…As diabetes and radiotherapy are known to influence GH levels these patients are not the ideal cohort to answer the study question. It is well known that in diabetic patients with poorly controlled glucose levels GH levels are higher and the physiological suppression of GH by glucose is reduced [30,31]. In acromegalic patients with poorly controlled diabetes GH levels might also be influenced and GH regulation after food intake might be altered.…”

Section: Discussionmentioning

confidence: 99%

The acute effect of a single application of cabergoline on endogenous GH levels in patients with acromegaly on pegvisomant treatment

Roemmler¹,

Steffin²,

Gutt³

et al. 2010

Growth Hormone & IGF Research

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Elevated serum growth hormone in a patient with Type 1 diabetes: a diagnostic dilemma

Cited by 18 publications

References 38 publications

Measurements of growth hormone and insulin‐like growth factor 1 in cats with diabetes mellitus

Measurements of growth hormone and insulin‐like growth factor 1 in cats with diabetes mellitus

Impact of Glucose Metabolism Disorders on IGF-1 Levels in Patients with Acromegaly

The acute effect of a single application of cabergoline on endogenous GH levels in patients with acromegaly on pegvisomant treatment

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