After 6years of intraperitoneal insulin administration IGF-I concentrations in T1DM patients are at low-normal level.
OBJECTIVE
Low concentrations of insulin-like growth factor-I (IGFI) have been reported in type 1 diabetes mellitus (T1DM), suggested to be due to low insulin concentrations in the portal vein. The aim was to describe the long-term course of IGFI concentrations among T1DM subjects treated with continuous intraperitoneal (IP) insulin infusion (CIPII).


METHODS
Nineteen patients that participated in a randomized cross-over trial comparing CIPII and subcutaneous (SC) insulin therapy in 2006 were followed until 2012. IGF-I measurements were performed at the start of the 2006 study, after the 6 month SC- and CIPII treatment phase in 2006 and during CIPII therapy in 2012. Z-scores were calculated to compare the IGF-I concentrations with age-specific normative range values of a non-DM reference population.


RESULTS
In 2012, IGF-I Z-scores (-0.7; 95% confidence interval -1.3, -0.2) were significantly higher than at the start of the 2006 study (-2.5; -3.3, -1.8), the end of the SC (-2.0; -2.6, -1.5) and CIPII (-1.6; -2.1, -1.0) treatment phase with a mean difference of: 1.8 (0.9, 2.7), 1.3 (0.5, 2.1) and 0.8 (0.1, 1.6), respectively.


CONCLUSIONS
After 6 years of treatment with CIPII, IGF-I concentrations among T1DM patients increased to a level that is higher than during prior SC insulin treatment and is in the lower normal range compared to a non-DM reference population. The results of this study suggest that long-term IP insulin administration influences the IGF system in T1DM.
Isala, Diabetes Centre, Zwolle, The Netherlands. Electronic address: P.r.van.Dijk@isala.nl.
Peter R
PR
van Dijk
Isala, Diabetes Centre, Zwolle, The Netherlands; University of Groningen, University Medical Center Groningen, Dept. of Internal Medicine, Groningen, The Netherlands.
Susan J J
SJ
Logtenberg
Linköping University, Dept. of Emergency Medicine, Linköping, Sweden; Linköping University, Dept. of Clinical and Experimental Medicine, Linköping, Sweden.
Simona I
SI
Chisalita
Linköping University, Dept. of Endocrinology, Linköping, Sweden; Linköping University, Dept. of Medical and Health Sciences, Linköping, Sweden.
Christina A
CA
Hedman
Isala, Diabetes Centre, Zwolle, The Netherlands; University of Groningen, University Medical Center Groningen, Dept. of General Practice, Groningen, The Netherlands.
Klaas H
KH
Groenier
University of Groningen, University Medical Center Groningen, Dept. of Internal Medicine, Groningen, The Netherlands.
Reinold O B
RO
Gans
Isala, Diabetes Centre, Zwolle, The Netherlands; University of Groningen, University Medical Center Groningen, Dept. of Internal Medicine, Groningen, The Netherlands; Langerhans Medical Research Group, Zwolle, The Netherlands.
Nanne
N
Kleefstra
Linköping University, Dept. of Clinical and Experimental Medicine, Linköping, Sweden; Linköping University, Dept. of Endocrinology, Linköping, Sweden.
Hans J
HJ
Arnqvist
Isala, Diabetes Centre, Zwolle, The Netherlands; University of Groningen, University Medical Center Groningen, Dept. of Internal Medicine, Groningen, The Netherlands; Isala, Dept. of Internal Medicine, Zwolle, The Netherlands.
Henk J G
HJ
Bilo
D000328:Adult; D015331:Cohort Studies; D003922:Diabetes Mellitus, Type 1 / Q000188:drug therapy* / Q000378:metabolism; D005260:Female; D006801:Humans; D007004:Hypoglycemic Agents / Q000008:administration & dosage*; D007263:Infusions, Parenteral; D007328:Insulin / Q000008:administration & dosage*; D007332:Insulin Infusion Systems; D007334:Insulin-Like Growth Factor I / Q000378:metabolism*; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies
D007004:Hypoglycemic Agents; D007328:Insulin; D007334:Insulin-Like Growth Factor I
IGF-I; Intraperitoneal insulin; Type 1 diabetes mellitus