title: Association of IGF1 with glycemic control and occurrence of severe hypoglycemia in patients with type 1 diabetes mellitus.
abstract: OBJECTIVE
  GH is implicated in the counter-regulatory response to hypoglycemia. We tested whether IGF1 levels are associated with occurrence of severe hypoglycemic events in patients with type 1 diabetes and whether the IGF1 concentration is influenced by glycemic control.
  
  
  METHODS
  A total of 228 outpatients with type 1 diabetes were included in a post hoc analysis of a 1-year observational study on severe hypoglycemia. Serum total IGF1 was measured at entry into the study. The occurrence of severe episodes of hypoglycemia, mild symptomatic, and biochemical as well as hypoglycemia awareness status was assessed. Also patients were included in a multiple regression analysis to investigate the role of HbA1c in the IGF1 concentration.
  
  
  RESULTS
  IGF1 levels were associated with neither severe hypoglycemia in the entire cohort (P=0.30) nor in any gender nor when confining the analysis to those with long-standing diabetes (>20 years) (n=112, P=0.68) and those with both long-standing diabetes and undetectable C-peptide (n=51, P=0.067). Levels of IGF1 were associated with neither mild symptomatic hypoglycemia (P=0.24) nor biochemical hypoglycemia (0.089) nor hypoglycemia awareness (P=0.16). At a multiple regression analysis, HbA1c was negatively associated with IGF1 (P=0.001).
  
  
  CONCLUSIONS
  In type 1 diabetes, circulating IGF1 levels are negatively associated with glycemic control. However, IGF1 levels were not associated with occurrence of hypoglycemia or hypoglycemia awareness in these patients.
authors.affiliation: Department of Cardiology, Nephrology and Endocrinology H Hillerød University Hospital Dyrehavevej 29DK-3400, Hillerød Denmark.
authors.forename: Louise
authors.initials: L
authors.lastname: Færch
authors.forename: Anders
authors.initials: A
authors.lastname: Juul
authors.forename: Ulrik
authors.initials: U
authors.lastname: Pedersen-Bjergaard
authors.forename: Birger
authors.initials: B
authors.lastname: Thorsteinsson
keywords: HbA1c; IGF1; hypoglycemia; type 1 diabetes