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Cited by 198Growth Hormone and Insulin-like Growth FactorsDiabetes Management and ResearchPancreatic function and diabetes

Importance of Raised Growth Hormone Levels in Mediating the Metabolic Derangements of Diabetes

Press, Martin, Tamborlane, William V., Sherwin, Robert S.·1984·New England Journal of Medicine
DOI 10.1056/nejm198403293101302
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Abstract

To evaluate the importance of the raised levels of growth hormone that characterize poor diabetic control, we gave growth hormone for 21 to 45 hours in the form of hourly 100-micrograms pulses to 14 diabetics being treated by insulin pump. Insulin-pump settings and meals were kept constant. Mean 24-hour levels of growth hormone (+/- S.E.M.) rose from 8 +/- 1 to 16 +/- 2 ng per milliliter--values identical to those observed in 12 other patients with poorly controlled diabetes (17 +/- 3 ng per milliliter). Plasma glucose concentrations doubled within 8 to 10 hours and remained elevated until growth hormone was discontinued (fasting glucose level rose from 86 +/- 11 to 204 +/- 17 mg per deciliter at 18 hours and to 240 +/- 20 mg per deciliter at 42 hours). The hyperglycemia was due mainly to a marked stimulation of hepatic glucose production that occurred without changes in levels of free insulin or glucagon. Levels of circulating free fatty acids, ketones, and branched-chain amino acids were also increased. The moderate elevations in growth hormone levels that occur in poorly controlled diabetes can themselves reproduce the whole spectrum of abnormal metabolic fuel concentrations that are associated with poor diabetic control, despite optimized insulin treatment. Thus, hypersecretion of growth hormone may be the cause as much as the consequence of poor diabetic control.

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Crossref · 10.1056/nejm198403293101302

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  • Sustained elevation of growth hormone levels is associated with a decrease in glucose sensitivity to insulin, both in the liver and in extrahepatic tissues.

    “Studies in patients with acromegaly [2] and in normal [3,4] and diabetic [5] man given GH for various periods of time have shown that sustained elevation of GH-levels is associated with a decrease in glucose sensitivity to insulin, both in the liver and in extrahepatic tissues.”

    From Effects of growth hormone on insulin sensitivity and forearm metabolism in normal man (1989) · cites this paper as [5]

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Authors
Press, M., Tamborlane, W. V., & Sherwin, R. S.
Affiliations
Yale University (US)
ORCID
Tamborlane, William V.
Venue
New England Journal of Medicine
Publisher
Massachusetts Medical Society
Published
1984-03-29
Volume
310
Issue
13
Pages
810-815
ISSN
  • 0028-4793 (ISSN-L)
  • 1533-4406
DOI
10.1056/nejm198403293101302
OpenAlex
W1985775724
Cited by
198
References
32
Citations by year
2024: 2 · 2023: 1 · 2019: 3 · 2018: 2 · 2017: 2 · 2016: 3 · 2013: 2
FWCI
11.66
Type
journal article
Language
en
Open access
closed
Locations
  • New England Journal of Medicine (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Growth Hormone and Insulin-like Growth Factors
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
  • Health Sciences › Medicine › Surgery › Pancreatic function and diabetes
Keywords
growth hormone, diabetes mellitus, poor glycemic control, hyperglycemia, hepatic glucose production, insulin pump therapy, free fatty acids, ketones, branched-chain amino acids, growth hormone hypersecretion, insulin resistance
MeSH terms
Adolescent, Adult, Blood Glucose, Diabetes Mellitus, Type 1, Female, Humans, Insulin Infusion Systems, Male, Growth Hormone

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