Insulin resistance and type 2 diabetes mellitus: is there a therapeutic role for IGF-1?
Severe insulin resistance represents a heterogeneous set of conditions with diverse underlying pathophysiology and limited therapeutic options. While recent studies have identified some of the molecular mechanisms resulting in extreme insulin resistance in peripheral tissues and liver, these studies have resulted in relatively few advances in therapy. Insulin like-growth factor 1 (IGF-1) lowers blood glucose while at the same time lowering serum insulin levels in normal volunteers. Its mechanism of action appears to be independent of activation of the insulin receptor although the role of IGF-1 in normal carbohydrate metabolism remains incompletely defined. IGF-1 also improves insulin resistance both in type 2 diabetes and in subjects with more severe insulin resistance. Small-scale clinical trials have demonstrated the potential utility of rhIGF-1 in selected cases of severe insulin resistance and, in these cases, the risk-benefit ratio appears to favor the use of this drug to ameliorate biochemical abnormalities and clinical symptoms.
Moses
Alan C
AC
Novo Nordisk Pharmaceuticals, Inc., Princeton, N.J., USA.
D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy* / Q000503:physiopathology; D006801:Humans; D007333:Insulin Resistance; D007334:Insulin-Like Growth Factor I / Q000627:therapeutic use*
D007334:Insulin-Like Growth Factor I