Long-term follow up in type A insulin resistant syndrome treated by insulin-like growth factor I.

Abstract

Insulin-like growth factor I (IGF-I) is a useful therapeutic agent in insulin resistant diabetes mellitus due to insulin receptor disease because of its hypoglycaemic effects through the IGF-I receptor. A girl with typical type A insulin resistant syndrome was treated with IGF-I for two years and the treatment was effective in ameliorating hyperglycaemia. Overproduction of testosterone in polycystic ovaries was aggravated with this treatment, however. Therefore, IGF-I treatment may be used for glycaemic control but with caution because of its possible side effect of aggravating hyperandrogenism in these patients.

Treatment with Recombinant Human Insulin-Like Growth Factor (rhIGF)-I/rhIGF Binding Protein-3 Complex Improves Metabolic Control in Subjects with Severe Insulin Resistance

“…In this study, rhIGF-I/rhIGFBP-3 did not lead to any deterioration in PCOS consistent with this hypothesis. However, in our short study we were not able to show any reduction in testosterone levels, and a previous study reported similar findings (39). Larger studies and perhaps longer periods of treatment are needed to determine full effects of treatment, and one way of achieving this might be to include subjects with Hyper Androgenism Insulin Resistance Acanthosis Nigracans (HAIR-AN) syndrome (34).…”

Cardiomyopathy in congenital complete lipodystrophy

“…Myocardial tissue contains high concentrations of IGF‐1 receptors: the frequent occurrence of hypertrophic cardiomyopathy in hyperinsulinaemic states, such as among infants of diabetic mothers (20), nesidioblastosis (20), Beckwith–Wiedemann syndrome (28), leprechaunism (27) and perhaps BSCL, may be the result of insulin action on cardiac IGF‐1 receptors. The similarity of effects of insulin and IGF‐1 has been used therapeutically, such as IGF‐1 administration to ameliorate the hyperglycaemia in insulin resistance (29, 30).…”

Effect of Metformin on Glucose Disposal and Hyperinsulinaemia in a 14-Year-Old Boy with Acanthosis Nigricans

“…Thus the slight improvement in hyperinsulinaemia observed during metformin therapy Metformin Therapy for Acanthosis Nigricans occurred during a period when hyperinsulinaemia would be expected to worsen considerably. Finally the study period may have been too short to observe any improve ment in the skin condition, as previous changes reported have occurred over several years of therapy [12],…”

“…Therapy has been largely unsuccessful consisting of topical keratolytic agents. Anti-androgen therapy [10], recombinant insulin like growth factor 1 [11,12] and dietary fish oil supple- mentation [13] have all been used with some improve ment.…”