Urinary Growth Hormone Excretion in Diabetic Children: Relation to Nocturnal Course of Blood Glucose Levels

ObjectiveAccording to current knowledge, glulisine insulin (GLU) has a slightly faster onset of action than aspart (ASP) insulin. Therefore, GLU might lead to a better postprandial profile than ASP following the consumption of high-glycemic index (H-GI) meals. The aim of this study was to assess differences in the action of GLU and ASP after the consumption of a H-GI meal in type 1 diabetic children treated with insulin pumps.DesignFifty-six type 1 diabetic children of mean age 14.7±2.0 years were included in a randomized, double-blind, two-way crossover study. The subjects were allocated to one of two treatment orders: GLU–ASP and ASP–GLU. They were given a H-GI breakfast for two subsequent days.MethodsThe primary outcome was postprandial glycemia (PPG) based on continuous glucose monitoring system and self monitoring of blood glucose levels during 3 h of follow-up. The secondary outcomes were the frequency of hypoglycemia, glucose area under the curve, mean amplitude of glycemic excursion, and glycemic rise.ResultsThere were no significant differences between the groups with regard to PPG in the determined time intervals as well as with respect to the secondary outcomes. Between 60 and 120 min after food consumption in both study groups, blood glucose levels were close to or above 10.0 mmol/l. Glucose peaks were higher in the GLU–ASP group than in the ASP–GLU group (90 min:P=0.065; 120 min:P=0.052). Most of the episodes of hypoglycemia were observed after the second hour of follow-up.ConclusionsNo statistically significant difference was found between GLU and ASP with regard to PPG after the consumption of a H-GI breakfast. Neither GLU nor ASP stabilized the glycemic profile after the consumption of a H-GI meal.

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Reduced autophagy in livers of fasted, fat-depleted, ghrelin-deficient mice: Reversal by growth hormone

Proceedings of the National Academy of Sciences ◽

10.1073/pnas.1423643112 ◽

2015 ◽

Vol 112 (4) ◽

pp. 1226-1231 ◽

Cited By ~ 43

Author(s):

Yuanyuan Zhang ◽

Fei Fang ◽

Joseph L. Goldstein ◽

Michael S. Brown ◽

Tong-Jin Zhao

Keyword(s):

Growth Hormone ◽

Blood Glucose ◽

Calorie Restriction ◽

Gene Encoding ◽

Glucose Levels ◽

Blood Glucose Levels ◽

Increase Blood Glucose ◽

Plasma Gh ◽

Deficient Mice

Plasma growth hormone (GH) and hepatic autophagy each have been reported to protect against hypoglycemia in the fasted state, but previous data have not linked the two. Here we demonstrate a connection using a mouse model of fasting in a fat-depleted state. Mice were subjected to 1 wk of 60% calorie restriction, causing them to lose nearly all body fat. They were then fasted for 23 h. During fasting, WT mice developed massive increases in plasma GH and a concomitant increase in hepatic autophagy, allowing them to maintain viable levels of blood glucose. In contrast, lethal hypoglycemia occurred in mice deficient in the GH secretagogue ghrelin as a result of knockout of the gene encoding ghrelin O-acyltransferase (GOAT), which catalyzes a required acylation of the peptide. Fasting fat-depleted Goat−/− mice showed a blunted increase in GH and a marked decrease in hepatic autophagy. Restoration of GH by infusion during the week of calorie restriction maintained autophagy in the Goat−/− mice and prevented lethal hypoglycemia. Acute injections of GH after 7 d of calorie restriction also restored hepatic autophagy, but failed to increase blood glucose, perhaps owing to ATP deficiency in the liver. These data indicate that GH stimulation of autophagy is necessary over the long term, but not sufficient over the short term to maintain blood glucose levels in fasted, fat-depleted mice.

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Can Type 1 Diabetic Children Predict Their Blood Glucose Levels Rightly?

JOURNAL OF THE JAPANESE ASSOCIATION OF RURAL MEDICINE ◽

10.2185/jjrm.48.884 ◽

2000 ◽

Vol 48 (6) ◽

pp. 884-890

Author(s):

Tatsuya HAGA ◽

Makoto NAGASHIMA ◽

Mika NAKAE ◽

Hideki KAMIYA ◽

Nachi KIMURA

Keyword(s):

Blood Glucose ◽

Glucose Levels ◽

Blood Glucose Levels ◽

Diabetic Children

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Low blood glucose levels and other complications during growth hormone supplementation in sepsis

Revista do Hospital das Clínicas ◽

10.1590/s0041-87811999000400007 ◽

1999 ◽

Vol 54 (4) ◽

pp. 135-138

Author(s):

Joel Faintuch ◽

Renata B. A. Leme ◽

Maria Emilia L. F. Cruz ◽

Angela M. B. Lima ◽

Daniel Giannella Neto ◽

...

Keyword(s):

Growth Hormone ◽

Blood Glucose ◽

Heart Arrest ◽

Tube Feeding ◽

Normal Range ◽

Peripheral Edema ◽

Glucose Levels ◽

Blood Glucose Levels ◽

Clinical Series ◽

High Calorie

Blood glucose levels in the high normal range or even moderate hyperglycemia is the expected profile in septic postoperative patients receiving high-calorie enteral alimentation. The addition of growth hormone as an anabolic agent should additionally reinforce this tendency. In a cancer patient undergoing partial gastrectomy with lymphadenectomy and suffering from postoperative subphrenic abscess and prolonged sepsis, tube feeding (38.3 kcal/kg/day) and growth hormone (0.17 IU/kg/day) were simultaneously administered for 25 days. Blood glucose levels were in the lower limits of the normal range before growth hormone introduction, and continued with a similar tendency during most of the therapeutic period. Two additional complications, namely heart arrest and peripheral edema, were documented during the same period. It is concluded that sepsis was the most likely mechanism for low glucose values, and that high-calorie enteral diet and growth hormone supplementation did not prevent that result. It is uncertain whether heart arrest was due to the drug, but its association with peripheral edema is well documented in clinical series.

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