title: Postprandial hyperglycemia corrected by IGF-I (Increlex®) in Laron syndrome.
abstract: BACKGROUND
  Laron syndrome is caused by a mutation in the growth hormone (GH) receptor and manifests as insulin-like growth factor-I (IGF-I) deficiency, severe short stature, and early hypoglycemia. We report a case with postprandial hyperglycemia, an abnormality not reported previously. Postprandial hyperglycemia was due to chronic IGF-I deficiency, and was reversed by IGF-I replacement therapy.
  
  
  METHODS
  A Moroccan girl referred for short stature at 7 years and 8 months of age had dwarfism [height, 78 cm (-9 SDs); weight, 10 kg (-4 SDs)], hypoglycemia, and truncal obesity. Her serum IGF-I level was very low, and her baseline serum GH level was elevated to 47 mIU/l. Molecular analysis showed a homozygous mutation in the GH receptor gene.
  
  
  RESULTS
  Continuous glucose monitoring before treatment showed asymptomatic hypoglycemia with postprandial hyperglycemia (2.5 g/l, 13.75 mmol/l). Treatment with recombinant human IGF-I (mecasermin, Increlex®) was started. The blood glucose profile improved with 0.04 µg/kg/day and returned to normal with 0.12 µg/kg/day.
  
  
  CONCLUSIONS
  Postprandial hyperglycemia is a metabolic consequence of chronic IGF-I deficiency. The beneficial effect of IGF-I replacement therapy may be ascribable to improved postprandial transfer of glucose.
authors.affiliation: Endocrinologie Diabétologie, Hôpital Militaire d'Instruction Mohammed V, Rabat, Maroc.
authors.forename: Hanane
authors.initials: H
authors.lastname: Latrech
authors.forename: Albane
authors.initials: A
authors.lastname: Simon
authors.forename: Jacques
authors.initials: J
authors.lastname: Beltrand
authors.forename: Jean-Claude
authors.initials: JC
authors.lastname: Souberbielle
authors.forename: Ghizlane
authors.initials: G
authors.lastname: Belmejdoub
authors.forename: Michel
authors.initials: M
authors.lastname: Polak
mesh_terms: D002648:Child; D005260:Female; D020249:Hormone Replacement Therapy; D006801:Humans; D006943:Hyperglycemia / Q000097:blood / Q000150:complications / Q000188:drug therapy*; D007334:Insulin-Like Growth Factor I / Q000627:therapeutic use*; D046150:Laron Syndrome / Q000097:blood / Q000150:complications / Q000188:drug therapy*; D011994:Recombinant Proteins / Q000627:therapeutic use
chemical_list: D011994:Recombinant Proteins; D007334:Insulin-Like Growth Factor I