Peter R van Dijk1, Susan J J Logtenberg2, Simona I Chisalita3, Christina A Hedman4, Klaas H Groenier5, Reinold O B Gans6, Nanne Kleefstra7, Hans J Arnqvist8, Henk J G Bilo9. 1. Isala, Diabetes Centre, Zwolle, The Netherlands. Electronic address: P.r.van.Dijk@isala.nl. 2. Isala, Diabetes Centre, Zwolle, The Netherlands; University of Groningen, University Medical Center Groningen, Dept. of Internal Medicine, Groningen, The Netherlands. 3. Linköping University, Dept. of Emergency Medicine, Linköping, Sweden; Linköping University, Dept. of Clinical and Experimental Medicine, Linköping, Sweden. 4. Linköping University, Dept. of Endocrinology, Linköping, Sweden; Linköping University, Dept. of Medical and Health Sciences, Linköping, Sweden. 5. Isala, Diabetes Centre, Zwolle, The Netherlands; University of Groningen, University Medical Center Groningen, Dept. of General Practice, Groningen, The Netherlands. 6. University of Groningen, University Medical Center Groningen, Dept. of Internal Medicine, Groningen, The Netherlands. 7. Isala, Diabetes Centre, Zwolle, The Netherlands; University of Groningen, University Medical Center Groningen, Dept. of Internal Medicine, Groningen, The Netherlands; Langerhans Medical Research Group, Zwolle, The Netherlands. 8. Linköping University, Dept. of Clinical and Experimental Medicine, Linköping, Sweden; Linköping University, Dept. of Endocrinology, Linköping, Sweden. 9. Isala, Diabetes Centre, Zwolle, The Netherlands; University of Groningen, University Medical Center Groningen, Dept. of Internal Medicine, Groningen, The Netherlands; Isala, Dept. of Internal Medicine, Zwolle, The Netherlands.
Abstract
OBJECTIVE: Low concentrations of insulin-like growth factor-I (IGFI) have been reported in type 1 diabetes mellitus (T1DM), suggested to be due to low insulin concentrations in the portal vein. The aim was to describe the long-term course of IGFI concentrations among T1DM subjects treated with continuous intraperitoneal (IP) insulin infusion (CIPII). DESIGN:Nineteen patients that participated in a randomized cross-over trial comparing CIPII and subcutaneous (SC) insulin therapy in 2006 were followed until 2012. IGF-I measurements were performed at the start of the 2006 study, after the 6 month SC- and CIPII treatment phase in 2006 and during CIPII therapy in 2012. Z-scores were calculated to compare the IGF-I concentrations with age-specific normative range values of a non-DM reference population. RESULTS: In 2012, IGF-I Z-scores (-0.7; 95% confidence interval -1.3, -0.2) were significantly higher than at the start of the 2006 study (-2.5; -3.3, -1.8), the end of the SC (-2.0; -2.6, -1.5) and CIPII (-1.6; -2.1, -1.0) treatment phase with a mean difference of: 1.8 (0.9, 2.7), 1.3 (0.5, 2.1) and 0.8 (0.1, 1.6), respectively. CONCLUSION: After 6 years of treatment with CIPII, IGF-I concentrations among T1DM patients increased to a level that is higher than during prior SC insulin treatment and is in the lower normal range compared to a non-DM reference population. The results of this study suggest that long-term IP insulin administration influences the IGF system in T1DM.
RCT Entities:
OBJECTIVE: Low concentrations of insulin-like growth factor-I (IGFI) have been reported in type 1 diabetes mellitus (T1DM), suggested to be due to low insulin concentrations in the portal vein. The aim was to describe the long-term course of IGFI concentrations among T1DM subjects treated with continuous intraperitoneal (IP) insulin infusion (CIPII). DESIGN: Nineteen patients that participated in a randomized cross-over trial comparing CIPII and subcutaneous (SC) insulin therapy in 2006 were followed until 2012. IGF-I measurements were performed at the start of the 2006 study, after the 6 month SC- and CIPII treatment phase in 2006 and during CIPII therapy in 2012. Z-scores were calculated to compare the IGF-I concentrations with age-specific normative range values of a non-DM reference population. RESULTS: In 2012, IGF-I Z-scores (-0.7; 95% confidence interval -1.3, -0.2) were significantly higher than at the start of the 2006 study (-2.5; -3.3, -1.8), the end of the SC (-2.0; -2.6, -1.5) and CIPII (-1.6; -2.1, -1.0) treatment phase with a mean difference of: 1.8 (0.9, 2.7), 1.3 (0.5, 2.1) and 0.8 (0.1, 1.6), respectively. CONCLUSION: After 6 years of treatment with CIPII, IGF-I concentrations among T1DM patients increased to a level that is higher than during prior SC insulin treatment and is in the lower normal range compared to a non-DM reference population. The results of this study suggest that long-term IP insulin administration influences the IGF system in T1DM.
Authors: Peter R van Dijk; Femke Waanders; Susan J J Logtenberg; Klaas H Groenier; Titia M Vriesendorp; Nanne Kleefstra; Harry van Goor; Henk J G Bilo Journal: Endocrinol Diabetes Metab Date: 2019-08-08
Authors: Peter R van Dijk; Femke Waanders; Andreas Pasch; Susan J J Logtenberg; Titia Vriesendorp; Klaas H Groenier; Jan-Luuk Hillebrands; Nanno Kleefstra; Rijk O B Gans; Harry van Goor; Henk J G Bilo Journal: Ther Adv Endocrinol Metab Date: 2020-03-03 Impact factor: 3.565