Effect of long-acting somatostatin analog (Somatulin) on renal hyperfiltration in patients with IDDM.
OBJECTIVE
To investigate whether long-acting somatostatin (SMS) can suppress renal hyperfiltration in patients with IDDM.


METHODS
A double-blind, randomized treatment of nine patients with IDDM was used. Selection criteria were renal hyperfiltration (glomerular filtration rate [GFR] > or = 129 ml.min-1.1.73 m2) and absence of hypertension and macroalbuminuria. Treatment was either with a long-acting SMS analog (Somatulin, 30 mg) or with placebo, given by intramuscular injections every 10 days for 9 months. GFR, effective renal plasma flow (ERPF), IGF-I, and 24-h growth hormone (GH) profiles were used as evaluation parameters.


RESULTS
Five patients were randomized to Somatulin, four patients to placebo. One of the patients treated with Somatulin stopped after 3 months because of persistent abdominal discomfort after the injections. Somatulin treatment for 3 months lowered GFR and ERPF compared with placebo (P < 0.05). After 9 months, the differences were no longer significant. After 3 months, IGF-I concentrations were decreased in all Somatulin-treated patients. GH secretion tended to increase in the placebo group.


CONCLUSIONS
The administration of long-acting Somatulin to patients with IDDM and renal hyperfiltration leads to only a temporary reduction of ERPF/GFR.
Jacobs
M L
ML
Department of Internal Medicine III, University Hospital Dijkzigt, Rotterdam, The Netherlands.
Derkx
F H
FH
Stijnen
T
T
Lamberts
S W
SW
Weber
R F
RF
D000328:Adult; D000419:Albuminuria / Q000453:epidemiology; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use*; D015415:Biomarkers / Q000097:blood; D003922:Diabetes Mellitus, Type 1 / Q000503:physiopathology*; D003928:Diabetic Nephropathies / Q000503:physiopathology / Q000517:prevention & control*; D003930:Diabetic Retinopathy / Q000453:epidemiology; D004311:Double-Blind Method; D005260:Female; D005919:Glomerular Filtration Rate / Q000187:drug effects*; D019382:Human Growth Hormone / Q000097:blood; D006801:Humans; D007334:Insulin-Like Growth Factor I / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D010456:Peptides, Cyclic / Q000627:therapeutic use*; D010919:Placebos; D012079:Renal Circulation / Q000187:drug effects*; D013004:Somatostatin / Q000031:analogs & derivatives* / Q000627:therapeutic use
D000894:Anti-Inflammatory Agents, Non-Steroidal; D015415:Biomarkers; D010456:Peptides, Cyclic; D010919:Placebos; C060347:lanreotide; D019382:Human Growth Hormone; D013004:Somatostatin; D007334:Insulin-Like Growth Factor I