Effect of growth hormone suppression on glycemic control and other hormonal changes in diabetic retinopathy

The study was carried out on ten insulin dependent diabetics suffering from different types of diabetic retinopathy to evaluate the effect of growth hormone suppression on glycemic control and other hormonal changes in diabetic retinopathy. Blood levels of HGH, prolactin, C-peptide, glucagon and A.C.T.H. were determined by RIA. Tests of glycemic control including glycosylated hemoglobin [HbA[1c]], fasting and postprandial blood sugar and total blood lipids were also estimated. Retinal changes were studied by fluorescein angiography. Bromocriptine was given to all cases for 12 weeks, in addition to standard therapy [insulin+ diet]. Pretreatment investigations were repeated at the end of the study. Pretreatment investigations showed significant elevation of glycosylated hemoglobin, fasting and postprandial blood sugar. Serum growth hormone, plasma glucagon and A.C.T.H. were significantly high. C-peptide was measurable in 30% of patients. After three months treatment, tests of glycemic control were significantly decreased. Serum GH and prolactin decreased significantly, while C-peptide was increased. Glucagon and A.C.T.H. showed no change. After treatment, retinal changes deteriorated in 60% of patients and this was attributed to a hypoglycemic effect

Hormonal and biochemical studies in diabetic retinopathy

Twenty type I [insulin-dependent] diabetic patients suffering from different grades of diabetic retinopathy were included in the study. The study aimed at investigating glycemic control and different hormones suspected to be sharing in the pathogenesis of diabetic retinopathy. Bad glycemic control was found in almost all patients with diabetic retinopathy. Significant elevation of serum growth hormone, glucagon and A.C.T.H. was found in diabetic retinopathy, while serum prolactin level was within normal. Residual beta cell function was found in 64% of patients with BDR [background diabetic retinopathy], while patients with PPDR [preproliferative diabetic retinopathy] and PDR [proliferative diabetic retinopathy] had no residual beta cell function. Higher grades of diabetic retinopathy were associated with bad glycemic control, higher levels of serum growth hormone and glucagon and absent residual beta cell function

Low plasma high density lipoprotein-cholesterol in non-insulin dependent diabetics

Fourteen subjects with non-insulin dependent diabetes mellitus [NIDDM] [8 males and 6 females] with normal plasma high density lipoprotein-cholcstcrol [HDL-C] [54 +/- 14.9 mg/dl] group I were compared to 20 patients with NIDDM [8 males and 12 females] with low plasma HDL-C [29 +/- 4.8 mg/dl] group 2. These subjects were selected from subjects attending the diabetes clinic at the Main Alexandria University Hospital according to plasma HDL-C levels. Mean age, duration of diabetes, fasting blood glucose, postprandial blood glucose, glycosylated hemoglobin, fasting plasma total cholesterol, low density lipoprotein-cholesterol, and C-peptide levels were comparable in both groups. Mean fasting plasma triglycerides [TG] was significantly elevated in group 2 [267.9 +/- 147.1 mg/dl] compared to that in group 1 subjects [150 +/- 29.7mg/dl] [P]. A significant inverse correlation was observed between plasma TG and HDL-C [P]. We can conclude that the decrease in HDL-C observed in some patients with NIDDM is not related to the degree of glycemic control, duration of diabetes, or insulin secretion; and that the reduction in HDL-C is associated with increase in TG