Combined therapy with insulin and growth hormone in 17 patients with type-1 diabetes and growth disorders.

Abstract

BACKGROUND/AIM:

Combined growth hormone (GH) and insulin therapy is rarely prescribed by pediatric endocrinologists. We investigated the attitude of Italian physicians to prescribing that therapy in the case of short stature and type-1 diabetes (T1DM).

METHODS:

A questionnaire was sent and if a patient was identified, data on growth and diabetes management were collected.

RESULTS:

Data from 42 centers (84%) were obtained. Of these, 29 centers reported that the use of combined therapy was usually avoided. A total of 17 patients were treated in 13 centers (GH was started before T1DM onset in 9 patients and after the onset of T1DM in 8). Height SDS patterns during GH therapy in the 11 patients affected by GH deficiency ranged from -0.3 to +3.1 SDS. In the 8 diabetic patients in whom GH was added subsequently, mean insulin dose increased during the first 6 months of therapy from 0.7 ± 0.2 to 1.0 ± 0.2 U/kg (p = 0.004). HbA1c was unchanged during the first 6 months of combined therapy.

CONCLUSIONS:

Most Italian physicians do not consider prescribing the combined GH-insulin therapy in diabetic children with growth problems. However, the results of the 17 patients identified would confirm that the combined therapy was feasible and only caused mild insulin resistance. GH therapy was effective in promoting growth in most patients and did not affect diabetes metabolic control.

• Authors: Stefano Zucchini, Dario Iafusco, Silvia Vannelli, Ivana Rabbone, Giuseppina Salzano, Gabriella Pozzobon, Mohamad Maghnie, Valentino Cherubini, Carla Bizzarri, Riccardo Bonfanti, Giuseppe D'Annunzio, Lorenzo Lenzi, Maria Cristina Maggio, Marco Marigliano, Andrea Scaramuzza, Stefano Tumini, Lorenzo Iughetti
• Journal: Hormone research in paediatrics (Horm Res Paediatr) Vol. 82 Issue 1 Pg. 53-8 ( 2014) ISSN: 1663-2826 [Electronic] Switzerland
• PMID: 24925520 (Publication Type: Journal Article, Multicenter Study)

Chemical References

• Hypoglycemic Agents
• Insulin
• Human Growth Hormone

Topics

• Adolescent
• Child
• Child, Preschool
• Diabetes Mellitus, Type 1 (complications, drug therapy)
• Drug Therapy, Combination
• Dwarfism, Pituitary (drug therapy)
• Female
• Growth Disorders (complications, drug therapy)
• Human Growth Hormone (administration & dosage)
• Humans
• Hypoglycemic Agents (administration & dosage)
• Insulin (administration & dosage)
• Insulin Resistance
• Male
• Surveys and Questionnaires