The effects of SMS 201-995 (sandostatin) on metabolic profiles in insulin-dependent diabetes mellitus.
GH has been implicated in the pathophysiology of various acute and chronic complications of diabetes mellitus. As a consequence, there has been a great deal of interest in developing methods for suppressing GH secretion in diabetes. SMS 201-995 is a long-acting somatostatin analog which inhibits the secretion of numerous hormones, including GH. To determine the metabolic and hormonal responses to SMS 201-995 independent of endogenous insulin suppression, we studied six patients with insulin-dependent diabetes mellitus while they received 150 micrograms SMS 201-995, sc, daily for an 8-week period. This treatment resulted in no change in 24-h glucose profiles, although the mean insulin dose decreased by 19%, while hemoglobin A1c decreased significantly (0.084 +/- 0.023 to 0.067 +/- 0.011, P = 0.04). The 24-h profiles of blood lactate, plasma free insulin, glucagon, FFA, blood glycerol, and beta-hydroxybutyrate were unchanged, whereas that of blood alanine increased significantly (7.8 +/- 0.4 to 10.6 +/- 0.9 mmol/L.h; P = 0.01). GH secretion declined in five of the six patients; the mean values before and during SMS 201-995 treatment were 102 +/- 23 and 68 +/- 12 micrograms/L.h, respectively (P = NS), for the six patients. [In the five patients in whom GH secretion declined, the mean values before and during SMS 201-995 treatment were 115 +/- 23 and 63 +/- 14 micrograms/L.h, respectively (P = 0.01).] These results suggest that SMS 201-995 may be administered to patients with insulin-dependent diabetes mellitus without a deleterious effect on metabolic control.
Grossman
L D
LD
Department of Medicine, University of Toronto, Ontario, Canada.
Shumak
S L
SL
George
S R
SR
Singer
W
W
Zinman
B
B
D000328:Adult; D000409:Alanine / Q000097:blood; D001786:Blood Glucose / Q000032:analysis; D003922:Diabetes Mellitus, Type 1 / Q000378:metabolism*; D005260:Female; D005934:Glucagon / Q000097:blood; D005990:Glycerol / Q000097:blood; D013006:Growth Hormone / Q000097:blood; D006441:Hemoglobin A / Q000032:analysis; D006801:Humans; D007328:Insulin / Q000008:administration & dosage / Q000097:blood; D007773:Lactates / Q000097:blood; D008297:Male; D015282:Octreotide / Q000494:pharmacology*
D001786:Blood Glucose; D007328:Insulin; D007773:Lactates; D013006:Growth Hormone; D005934:Glucagon; D006441:Hemoglobin A; D000409:Alanine; D005990:Glycerol; D015282:Octreotide