Short-term effects of NPH insulin, insulin detemir, and insulin glargine on the GH–IGF1–IGFBP axis in patients with type 1 diabetes

Ma, Zeyu; Christiansen, Jens Sandahl; Laursen, Torben; Lauritzen, Torsten; Frystyk, Jan

doi:10.1530/eje-14-0258

Cited by 11 publications

(5 citation statements)

References 34 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In vivo a single dose of IDet in relation to NPH or IGla was found to cause higher levels of bioactive IGF1 but not total IGF1. This finding was accompanied by a larger suppression of IGFBP1 with consecutive lower GH concentrations 8 . Other studies reported no differences between IDet and NPH or IDet and IGla regarding the GH‐IGF1‐IGFBP axis 20,21 .…”

Section: Discussionmentioning

confidence: 86%

See 1 more Smart Citation

Choice of basal insulin therapy is associated with weight and height development in type 1 diabetes: A multicenter analysis from theGerman/Austrian DPVregistry in 10 338 children and adolescents

Vollbach

Auzanneau

Reinehr

et al. 2021

Journal of Diabetes

View full text Add to dashboard Cite

Background Available basal insulin regimes differ in pharmacokinetic profiles, which may be related to subsequent changes in anthropometry in patients with type 1 diabetes. This analysis elucidates the standardized height and body mass index development (height and BMI standard deviation score [height‐SDS and BMI‐SDS]) in pediatric type 1 diabetes patients depending on the choice of basal insulin. Methods Longitudinal data of 10 338 German/Austrian patients from the Diabetes Prospective Follow‐up (DPV, Diabetes Patienten Verlaufsdokumentation) database were analyzed. Patients aged 5.0 to 16.9 years were treated exclusively with neutral protamine Hagedorn (NPH), insulin detemir (IDet), insulin glargine (IGla), or continuous subcutaneous insulin infusion (CSII) for at least 3 years. Population‐based German reference data were used to calculate height‐SDS and BMI‐SDS. Multiple linear regression was conducted. Results BMI‐SDS increased significantly in all regimes (NPH P = .0365; IDet P = .0003; IGla P < .0001; and CSII P < .0001). Direct comparison of the therapies revealed a favorable association only for NPH vs IGla. A rise in BMI‐SDS was observed for all insulins in females, but only for IGla in males. BMI‐SDS increment was not observed before 8 years of age. Initially and at the end of the observation period, mean height was above the 50th percentile of the reference population. Across the cohort, height‐SDS declined during the observation period, except for CSII. Apart from the 5.0‐ to 7.9‐year‐old subgroup, long‐acting insulin analogues were associated with a significant loss of height‐SDS. Conclusions Choice of basal insulin regimen might influence height development. CSII appeared to have a favorable effect on growth trajectories. All therapies were associated with an increase of BMI‐SDS, most evident in females.

show abstract

Section: Discussionmentioning

confidence: 86%

“…Due to its liver specificity, IDet might partially compensate portal insulinopenia and thereby GH hypersecretion. Recent reports suspected that this has a favorable impact on weight gain 7,8 …”

Section: Introductionmentioning

confidence: 99%

Choice of basal insulin therapy is associated with weight and height development in type 1 diabetes: A multicenter analysis from theGerman/Austrian DPVregistry in 10 338 children and adolescents

Vollbach

Auzanneau

Reinehr

et al. 2021

Journal of Diabetes

View full text Add to dashboard Cite

show abstract

“…Detemir has a myristic (C14) acid substitution at a terminal B29 lysine (no threonine), and its slow action is attributable to hydrophobic self-association in tissues and also to binding of the acyl chain to fatty acid binding sites on serum albumin. 6,20 A further flattened profile is associated with degludec (t1/2 ~25 hours, duration >40 hours) and is enabled because, despite its superficial similarity to detemir, its des-30-structure (again no threonine) forms very long unique hexameric sequences stabilised by zinc, phenol and hydrophobic contact between covalently attached hexadecanoic (C16) diacid chains linked at B29 with glutamic acid. 9,19 These lipophilic agents therefore differ from an alternative soluble long-acting insulin, glargine, which has a replacement of glycine for asparagine at position A21 and addition of two arginine molecules at positions B29-30.…”

Section: Development Of Injectable Insulins For Intensive Control Reg...mentioning

confidence: 99%

Glucose lowering strategies with insulin

2019

View full text Add to dashboard Cite

People with type 1 diabetes must use insulin and a large fraction of those with type 2 condition also do so. Many therefore struggle with the unpredictable balancing of insulin dose with calorie intake and utility. A healthy pancreas makes meticulous adjustment on a continuous basis that present therapeutic insulin administration cannot match. However, much progress has been made to make it simpler to inject both background and fast-acting boost insulins with a view to better mimicking normal pancreatic output. The present fast insulins are reviewed with accent on the primary amino acid structures of the biosynthetic types that diffuse more quickly than regular insulin that associates in hexamers. This makes boost doses kinetically and clinically more effective, allowing people to inject better estimated boost and corrective doses. Formulation advances are discussed for their present and potential contributions. The newer slow-acting insulins are also described and compared, their advantage also being kinetic with a lower likelihood of inducing overnight hypoglycaemia when used optimally. Finally, the appreciation of the advantages of alternative routes of administration such as oral and peritoneal are included in this review because of the possibility of altering the hepatic to peripheral ratio, the reasons for which are more effective but less obesogenic insulin activity. The logistics of oral insulin are summarised in terms of the risks to the insulin structure, the facilitation of paracellular uptake at the apical surface and the paradoxically advantageous hepatic first pass. Other non-invasive routes are also included in the review.

show abstract

“…Such effects have been observed with intraperitoneal insulin infusions, 10,11,72 direct intraportal insulin administration, 13 and hepatoselective insulins, as well as with long-acting parenteral insulin with a circulating depot, such as insulin detemir, which appears to possess an increased liver specificity. 18,71,73 Insulin increases the sensitivity of the liver to growth hormone (GH) by upregulating GH receptor expression, thereby augmenting insulin-like growth factor-1 (IGF-1) production. 74 In addition, it downregulates IGF binding protein-1 (IGFBP-1) production in the liver, thereby increasing circulating IGF-1 bioactivity.…”

Section: Potential Benefits Of Portal Insulin Administration Beyond Gmentioning

confidence: 99%

Oral Insulin Delivery in a Physiologic Context: Review

Arbit¹,

Kidron²

2017

J Diabetes Sci Technol

View full text Add to dashboard Cite

Insulin remains indispensable to the treatment of diabetes, but its availability in injectable form only has hampered its timely and broader use. The development of an oral insulin remains an ultimate goal to both enhance ease of use, and to provide therapeutic advantages rooted in its direct delivery to the portal vein and liver. By mimicking the physiological path taken by pancreatic insulin, oral insulin is expected to have a distinct effect on the hepatic aspect of carbohydrate metabolism, hepatic insulin resistance, and, at the same time, avoid hyperinsulinemia and minimize the risk of hypoglycemia. With oral insulin approaching late stages of development, the goal of this review is to examine oral insulin in a physiological context and report on recent progress in its development.

show abstract

Short-term effects of NPH insulin, insulin detemir, and insulin glargine on the GH–IGF1–IGFBP axis in patients with type 1 diabetes

Cited by 11 publications

References 34 publications

Choice of basal insulin therapy is associated with weight and height development in type 1 diabetes: A multicenter analysis from theGerman/Austrian DPVregistry in 10 338 children and adolescents

Choice of basal insulin therapy is associated with weight and height development in type 1 diabetes: A multicenter analysis from theGerman/Austrian DPVregistry in 10 338 children and adolescents

Glucose lowering strategies with insulin

Oral Insulin Delivery in a Physiologic Context: Review

Contact Info

Product

Resources

About