Document Detail


Nocturnal blood glucose and IGFBP-1 changes in type 1 diabetes: Differences in the dawn phenomenon between insulin regimens.
MedLine Citation:
PMID:  19834874     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: Insulin-like growth factor binding protein-1 (IGFBP-1) is known to regulate the bioavailability of insulin-like growth factor (IGF) and the levels of IGFBP-1 are increased in the morning in patients with type 1 diabetes mellitus. We investigated the nocturnal fluctuations of glucose, IGFBP-1, and free IGF-1 levels with three insulin regimens. RESEARCH DESIGN AND METHODS: Forty-eight type 1 diabetes patients were divided into three groups according to their basal insulin therapy (continuous subcutaneous insulin infusion [CSII], insulin glargine, NPH insulin). Blood samples were obtained every 2 h between 2 300 h and 0700 h to measure plasma glucose, IGFBP-1 and free IGF-1 levels. RESULTS: The dawn phenomenon was more frequent with NPH (62.1%) than with glargine (16.6%, p<0.05) and CSII (14.3%, p<0.05). In the NPH group, the serum IGFBP-1 levels were markedly increased from 21.0+/-3.6 ng/ml at 2 300 h to 200.3+/-21.8 ng/ml at 0700 h and free IGF-1 levels were inversely decreased; these changes were partially suppressed in the CSII and glargine groups. CONCLUSIONS: The use of insulin regimens that provide sufficient insulin levels in the early morning can suppress the dawn phenomenon, leading to improved glycemic control. The increase in circulating IGFBP-1 in the morning, as a result of waning of insulin action, lowers free IGF-1 levels and may cause insulin resistance.
Authors:
H Yagasaki; K Kobayashi; T Saitou; K Nagamine; Y Mitsui; M Mochizuki; K Kobayashi; H Cho; K Ohyama; S Amemiya; S Nakazawa
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Publication Detail:
Type:  Comparative Study; Journal Article     Date:  2009-10-15
Journal Detail:
Title:  Experimental and clinical endocrinology & diabetes : official journal, German Society of Endocrinology [and] German Diabetes Association     Volume:  118     ISSN:  1439-3646     ISO Abbreviation:  Exp. Clin. Endocrinol. Diabetes     Publication Date:  2010 Mar 
Date Detail:
Created Date:  2010-03-15     Completed Date:  2010-06-24     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9505926     Medline TA:  Exp Clin Endocrinol Diabetes     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  195-9     Citation Subset:  IM    
Copyright Information:
J. A. Barth Verlag in Georg Thieme Verlag KG Stuttgart * New York.
Affiliation:
Department of Pediatrics, University of Yamanashi, Japan. yagasaki@mwd.biglobe.ne.jp
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Blood Glucose / analysis,  metabolism*
Circadian Rhythm / physiology
Diabetes Mellitus, Type 1 / blood,  drug therapy*,  metabolism
Female
Humans
Insulin / administration & dosage*,  analogs & derivatives*,  therapeutic use
Insulin Infusion Systems
Insulin, NPH / administration & dosage*,  therapeutic use
Insulin-Like Growth Factor Binding Protein 1 / blood,  metabolism*
Insulin-Like Growth Factor I / analysis
Male
Chemical
Reg. No./Substance:
0/Blood Glucose; 0/Insulin-Like Growth Factor Binding Protein 1; 0/glargine; 11061-68-0/Insulin; 53027-39-7/Insulin, NPH; 67763-96-6/Insulin-Like Growth Factor I

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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