Combined therapy with insulin and growth hormone in 17 patients with type-1 diabetes and growth disorders

Stefano Zucchini, Dario Iafusco, Silvia Vannelli, Ivana Rabbone, Giuseppina Salzano, Gabriella Pozzobon, Mohamad Maghnie, Valentino Cherubini, Carla Bizzarri, Riccardo Bonfanti, Giuseppe D'Annunzio, Lorenzo Lenzi, Maria Cristina Maggio, Marco Marigliano, Andrea Scaramuzza, Stefano Tumini, Lorenzo Iughetti

Research output: Contribution to journalArticle

Abstract

Background/Aim: Combined growth hormone (GH) and insulin therapy is rarely prescribed by pediatric endocrinologists. We investigated the attitude of Italian physicians to prescribing that therapy in the case of short stature and type-1 diabetes (T1DM). Methods: A questionnaire was sent and if a patient was identified, data on growth and diabetes management were collected. Results: Data from 42 centers (84%) were obtained. Of these, 29 centers reported that the use of combined therapy was usually avoided. A total of 17 patients were treated in 13 centers (GH was started before T1DM onset in 9 patients and after the onset of T1DM in 8). Height SDS patterns during GH therapy in the 11 patients affected by GH deficiency ranged from -0.3 to +3.1 SDS. In the 8 diabetic patients in whom GH was added subsequently, mean insulin dose increased during the first 6 months of therapy from 0.7 ± 0.2 to 1.0 ± 0.2 U/kg (p = 0.004). HbA1c was unchanged during the first 6 months of combined therapy. Conclusions: Most Italian physicians do not consider prescribing the combined GH-insulin therapy in diabetic children with growth problems. However, the results of the 17 patients identified would confirm that the combined therapy was feasible and only caused mild insulin resistance. GH therapy was effective in promoting growth in most patients and did not affect diabetes metabolic control.

Original languageEnglish
Pages (from-to)53-58
Number of pages6
JournalHormone Research in Paediatrics
Volume82
Issue number1
DOIs
Publication statusPublished - 2014

Fingerprint

Growth Disorders
Type 1 Diabetes Mellitus
Growth Hormone
Insulin
Therapeutics
Growth
Physicians
Insulin Resistance
Pediatrics

Keywords

  • GH deficiency
  • Growth hormone
  • Insulin therapy
  • Turner syndrome
  • Type-1 diabetes

ASJC Scopus subject areas

  • Endocrinology
  • Endocrinology, Diabetes and Metabolism
  • Pediatrics, Perinatology, and Child Health
  • Medicine(all)

Cite this

Zucchini, S., Iafusco, D., Vannelli, S., Rabbone, I., Salzano, G., Pozzobon, G., ... Iughetti, L. (2014). Combined therapy with insulin and growth hormone in 17 patients with type-1 diabetes and growth disorders. Hormone Research in Paediatrics, 82(1), 53-58. https://doi.org/10.1159/000360856

Combined therapy with insulin and growth hormone in 17 patients with type-1 diabetes and growth disorders. / Zucchini, Stefano; Iafusco, Dario; Vannelli, Silvia; Rabbone, Ivana; Salzano, Giuseppina; Pozzobon, Gabriella; Maghnie, Mohamad; Cherubini, Valentino; Bizzarri, Carla; Bonfanti, Riccardo; D'Annunzio, Giuseppe; Lenzi, Lorenzo; Maggio, Maria Cristina; Marigliano, Marco; Scaramuzza, Andrea; Tumini, Stefano; Iughetti, Lorenzo.

In: Hormone Research in Paediatrics, Vol. 82, No. 1, 2014, p. 53-58.

Research output: Contribution to journalArticle

Zucchini, S, Iafusco, D, Vannelli, S, Rabbone, I, Salzano, G, Pozzobon, G, Maghnie, M, Cherubini, V, Bizzarri, C, Bonfanti, R, D'Annunzio, G, Lenzi, L, Maggio, MC, Marigliano, M, Scaramuzza, A, Tumini, S & Iughetti, L 2014, 'Combined therapy with insulin and growth hormone in 17 patients with type-1 diabetes and growth disorders', Hormone Research in Paediatrics, vol. 82, no. 1, pp. 53-58. https://doi.org/10.1159/000360856
Zucchini, Stefano ; Iafusco, Dario ; Vannelli, Silvia ; Rabbone, Ivana ; Salzano, Giuseppina ; Pozzobon, Gabriella ; Maghnie, Mohamad ; Cherubini, Valentino ; Bizzarri, Carla ; Bonfanti, Riccardo ; D'Annunzio, Giuseppe ; Lenzi, Lorenzo ; Maggio, Maria Cristina ; Marigliano, Marco ; Scaramuzza, Andrea ; Tumini, Stefano ; Iughetti, Lorenzo. / Combined therapy with insulin and growth hormone in 17 patients with type-1 diabetes and growth disorders. In: Hormone Research in Paediatrics. 2014 ; Vol. 82, No. 1. pp. 53-58.
@article{df5d939b6ef24376b2e099e8b292f7ca,
title = "Combined therapy with insulin and growth hormone in 17 patients with type-1 diabetes and growth disorders",
abstract = "Background/Aim: Combined growth hormone (GH) and insulin therapy is rarely prescribed by pediatric endocrinologists. We investigated the attitude of Italian physicians to prescribing that therapy in the case of short stature and type-1 diabetes (T1DM). Methods: A questionnaire was sent and if a patient was identified, data on growth and diabetes management were collected. Results: Data from 42 centers (84{\%}) were obtained. Of these, 29 centers reported that the use of combined therapy was usually avoided. A total of 17 patients were treated in 13 centers (GH was started before T1DM onset in 9 patients and after the onset of T1DM in 8). Height SDS patterns during GH therapy in the 11 patients affected by GH deficiency ranged from -0.3 to +3.1 SDS. In the 8 diabetic patients in whom GH was added subsequently, mean insulin dose increased during the first 6 months of therapy from 0.7 ± 0.2 to 1.0 ± 0.2 U/kg (p = 0.004). HbA1c was unchanged during the first 6 months of combined therapy. Conclusions: Most Italian physicians do not consider prescribing the combined GH-insulin therapy in diabetic children with growth problems. However, the results of the 17 patients identified would confirm that the combined therapy was feasible and only caused mild insulin resistance. GH therapy was effective in promoting growth in most patients and did not affect diabetes metabolic control.",
keywords = "GH deficiency, Growth hormone, Insulin therapy, Turner syndrome, Type-1 diabetes",
author = "Stefano Zucchini and Dario Iafusco and Silvia Vannelli and Ivana Rabbone and Giuseppina Salzano and Gabriella Pozzobon and Mohamad Maghnie and Valentino Cherubini and Carla Bizzarri and Riccardo Bonfanti and Giuseppe D'Annunzio and Lorenzo Lenzi and Maggio, {Maria Cristina} and Marco Marigliano and Andrea Scaramuzza and Stefano Tumini and Lorenzo Iughetti",
year = "2014",
doi = "10.1159/000360856",
language = "English",
volume = "82",
pages = "53--58",
journal = "Hormone Research in Paediatrics",
issn = "1663-2818",
publisher = "S. Karger AG",
number = "1",

}

TY - JOUR

T1 - Combined therapy with insulin and growth hormone in 17 patients with type-1 diabetes and growth disorders

AU - Zucchini, Stefano

AU - Iafusco, Dario

AU - Vannelli, Silvia

AU - Rabbone, Ivana

AU - Salzano, Giuseppina

AU - Pozzobon, Gabriella

AU - Maghnie, Mohamad

AU - Cherubini, Valentino

AU - Bizzarri, Carla

AU - Bonfanti, Riccardo

AU - D'Annunzio, Giuseppe

AU - Lenzi, Lorenzo

AU - Maggio, Maria Cristina

AU - Marigliano, Marco

AU - Scaramuzza, Andrea

AU - Tumini, Stefano

AU - Iughetti, Lorenzo

PY - 2014

Y1 - 2014

N2 - Background/Aim: Combined growth hormone (GH) and insulin therapy is rarely prescribed by pediatric endocrinologists. We investigated the attitude of Italian physicians to prescribing that therapy in the case of short stature and type-1 diabetes (T1DM). Methods: A questionnaire was sent and if a patient was identified, data on growth and diabetes management were collected. Results: Data from 42 centers (84%) were obtained. Of these, 29 centers reported that the use of combined therapy was usually avoided. A total of 17 patients were treated in 13 centers (GH was started before T1DM onset in 9 patients and after the onset of T1DM in 8). Height SDS patterns during GH therapy in the 11 patients affected by GH deficiency ranged from -0.3 to +3.1 SDS. In the 8 diabetic patients in whom GH was added subsequently, mean insulin dose increased during the first 6 months of therapy from 0.7 ± 0.2 to 1.0 ± 0.2 U/kg (p = 0.004). HbA1c was unchanged during the first 6 months of combined therapy. Conclusions: Most Italian physicians do not consider prescribing the combined GH-insulin therapy in diabetic children with growth problems. However, the results of the 17 patients identified would confirm that the combined therapy was feasible and only caused mild insulin resistance. GH therapy was effective in promoting growth in most patients and did not affect diabetes metabolic control.

AB - Background/Aim: Combined growth hormone (GH) and insulin therapy is rarely prescribed by pediatric endocrinologists. We investigated the attitude of Italian physicians to prescribing that therapy in the case of short stature and type-1 diabetes (T1DM). Methods: A questionnaire was sent and if a patient was identified, data on growth and diabetes management were collected. Results: Data from 42 centers (84%) were obtained. Of these, 29 centers reported that the use of combined therapy was usually avoided. A total of 17 patients were treated in 13 centers (GH was started before T1DM onset in 9 patients and after the onset of T1DM in 8). Height SDS patterns during GH therapy in the 11 patients affected by GH deficiency ranged from -0.3 to +3.1 SDS. In the 8 diabetic patients in whom GH was added subsequently, mean insulin dose increased during the first 6 months of therapy from 0.7 ± 0.2 to 1.0 ± 0.2 U/kg (p = 0.004). HbA1c was unchanged during the first 6 months of combined therapy. Conclusions: Most Italian physicians do not consider prescribing the combined GH-insulin therapy in diabetic children with growth problems. However, the results of the 17 patients identified would confirm that the combined therapy was feasible and only caused mild insulin resistance. GH therapy was effective in promoting growth in most patients and did not affect diabetes metabolic control.

KW - GH deficiency

KW - Growth hormone

KW - Insulin therapy

KW - Turner syndrome

KW - Type-1 diabetes

UR - http://www.scopus.com/inward/record.url?scp=84906938469&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84906938469&partnerID=8YFLogxK

U2 - 10.1159/000360856

DO - 10.1159/000360856

M3 - Article

C2 - 24925520

AN - SCOPUS:84906938469

VL - 82

SP - 53

EP - 58

JO - Hormone Research in Paediatrics

JF - Hormone Research in Paediatrics

SN - 1663-2818

IS - 1

ER -