Serum Free Immunoreactive Insulin in Poorly Controlled Diabetic Children

Åkerblom, Hans K.; Käär, M.-L.; Knip, Mikael; Puukka, Raija

doi:10.1515/jpem.1985.1.2-3.151

Cited by 2 publications

(2 citation statements)

References 7 publications

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“…Griffin and coworkers [131 showed that plasma free insulin concentrations decreased during night-time and reached a nadir of about 5 mU/1 at 08.00 hours in 15 children aged 10 to 17 years who were on once-daily insulin injections, but low concentrations were missing in another study of pubertal diabetic children who received twice-daily insulin injections [14]. An earlier Finnish study revealed that the serum free insulin values were lowest in the morning in 12 diabetic children aged 3 to 15 years who had been hospitalized because of poor control [15]. In another small group of pubertal children with IDDM for 1.5-10.7 years, plasma free insulin concentrations declined linearly overnight and reached a nadir in the morning [18].…”

Section: Discussionmentioning

confidence: 95%

Serum insulin profiles in consecutive children 2 years after the diagnosis of IDDM

Simell

Mäenpää²,

Kaprio

et al. 1995

Diabetologia

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We studied associations of 24-h serum insulin profiles with insulin dose, age, gender, haemoglobin A1c (HbA1c) and C-peptide values, as well as blood glucose profiles in 77 consecutive children-nine aged 2-4, 14 aged 5-8, 26 aged 9-12, and 28 aged 13-17 years--2 years after the onset of insulin-dependent diabetes mellitus (IDDM). Mean weight-based insulin doses in the four age groups were similar (0.7 +/- 0.2 U.kg-1.day-1 in all); body surface-area-based doses differed. Insulin doses correlated significantly with the 24-h mean and area-under-the-curve (AUC) values, and with mean values at 03.00 hours of serum insulin in the children aged 5-8 and 13-17 years. The mean insulin concentrations of the age groups (95% confidence intervals) increased with age [6.1 (3.8, 9.7), 7.6 (5.9, 9.8), 10.4 (8.6, 12.4), and 14.0 (11.6, 16.8) mU/l; p < 0.0002]. The 24-h mean of serum insulin together with HbA1c concentration predicted 32% of the variation of mean blood glucose concentrations. Of children aged less than 9 years, 50% had insulin values less than 5 mU/l (healthy subjects' lower reference limit), and 14% were of less than 2 mU/l (detection limit of the assay) at 03.00 hours. At 07.00 hours, 82% had insulin values of less than 5 mU/l, and 36% were of less than 2 mU/l, respectively. Some young children had night-time hypoglycaemia with simultaneous hypoinsulinaemia. Insulin profiles correlated poorly with the HbA1c and peak C-peptide values.(ABSTRACT TRUNCATED AT 250 WORDS)

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Section: Discussionmentioning

confidence: 95%

Serum insulin profiles in consecutive children 2 years after the diagnosis of IDDM

Simell

Mäenpää²,

Kaprio

et al. 1995

Diabetologia

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“…IGFBP-1 has a diurnal rhythm regulated by insulin, and subjects with IDDM show their highest levels in the early morning hours, when insulin tends to wane (26). Morning hypoinsulinemia is also a characteristic feature of poorly controlled diabetic subjects, resulting in hyperglycemia and ketonemia (27). Accordingly, transient morning hypoinsulinemia may be the common denominator for both low peripheral IGF-I concentrations and impaired glycemic control and may provide an explanation for the observed relationship between poor metabolic control and low IGF-I levels.…”

Section: Discussionmentioning

confidence: 99%

Normal stimulated growth hormone secretion but low peripheral levels of insulin‐like growth factor I in prepubertal children with insulin‐dependent diabetes mellitus

Tapanainen¹,

Käär²,

Leppäluoto

et al. 1995

Acta Paediatrica

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The hypothalamo-pituitary-insulin-like growth factor I (IGF-I) axis was studied in 24 prepubertal children with insulin-dependent diabetes mellitus (IDDM) and 12 non-diabetic children. There were no significant differences between the diabetic and control subjects in basal concentrations of immunoreactive growth hormone releasing hormone (ir-GHRH), growth hormone (GH) or stimulated GH levels, but after exercise ir-GHRH concentrations were higher in the diabetic children. Peripheral IGF-I levels were significantly lower in the diabetic children, and even lower in those with poor metabolic control. A positive correlation was found between IGF-I levels and circulating free insulin concentrations in the diabetic subjects (r = 0.49, p < 0.05). These observations suggest that the GH response to physiological stimulation is normal in prepubertal diabetic children. Exercise-induced GH response may not be mediated by GHRH. IGF-I levels were reduced in prepubertal children with IDDM and even more so in subjects with poor metabolic control. This may be a consequence of transitory hypoinsulineamia, emphasizing the importance of adequate insulinization to facilitate optimal growth in children and adolescents with IDDM.

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Serum Free Immunoreactive Insulin in Poorly Controlled Diabetic Children

Cited by 2 publications

References 7 publications

Serum insulin profiles in consecutive children 2 years after the diagnosis of IDDM

Serum insulin profiles in consecutive children 2 years after the diagnosis of IDDM

Normal stimulated growth hormone secretion but low peripheral levels of insulin‐like growth factor I in prepubertal children with insulin‐dependent diabetes mellitus

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