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- Title
Insulin sensitivity and lipolysis in adolescent girls with poorly controlled type 1 diabetes: effect of anticholinergic treatment.
- Authors
Halldin, M. U.; Brismar, K.; Tuvemo, T.; Gustafsson, J.
- Abstract
Summary Objectives Increased GH secretion could be one factor behind the impaired glycaemic control often seen in adolescent girls with type 1 diabetes. Because GH induces insulin resistance, treatment with anticholinergic agents, such as pirenzepine (PZP), has been used to reduce GH secretion. However, in a previous study of adolescent girls with type 1 diabetes, we observed an improvement in glycaemic control during 12 weeks of PZP therapy despite unchanged excretion of GH in urine. Considering the complex mechanisms behind urinary GH excretion, the effects of PZP on pituitary GH secretion or secretory pattern cannot be excluded. Thus, to assess the effect of anticholinergic treatment on metabolic control in adolescent girls with diabetes, we have investigated GH secretion, insulin sensitivity and lipolysis before and during treatment with PZP. Patients Eleven adolescent girls with type 1 diabetes and poor metabolic control were investigated before and after treatment with PZP, 100 mg orally, twice a day for 3 weeks. Design Serum samples for analysis of haemoglobin A1c and IGF-I were obtained in addition to serum profiles of GH, insulin and IGFBP-1 before and after 3 weeks of PZP treatment. Effects on insulin sensitivity and lipolysis were also assessed. Measurements IGFBP-1 was measured every hour, whereas serum GH and insulin were measured every 20 min for 24 h. Insulin sensitivity was analysed with the hyperinsulinaemic euglycaemic clamp technique. The rate of lipolysis was assessed under basal conditions following a constant rate infusion of [1,1,2,3,3-2 H5 ]-glycerol. In five girls, lipolysis was also estimated during the hyperinsulinaemic euglycaemic clamp. Results There was a significant reduction in haemoglobin A1c levels (9·9 ± 0·2%vs. 9·1 ± 0·2; P < 0·0001) during 3 weeks of PZP treatment. In additional, the glucose requirement during the euglycaemic hyperinsulinaemic clamp increased by more...
- Subjects
DIABETES in adolescence; INSULIN; LIPOLYSIS
- Publication
Clinical Endocrinology, 2002, Vol 57, Issue 6, p735
- ISSN
0300-0664
- Publication type
Article
- DOI
10.1046/j.1365-2265.2002.01656.x