[Nocturnal use of pirenzepine in young insulin dependent diabetics. Results of a 6-months treatment period]. / Uso de pirenzepina oral nocturna en jóvenes diabéticos insulino-dependientes. Resultados tras 6 meses de tratamiento.

Previous studies have demonstrated an elevation in GH in adult insulin-dependent diabetics which can be modified by administration of pirenzepina either IV or orally. In this study we have evaluated the mean nocturnal GH levels (MNGH) and HbA1-C levels in a group of young insulin-dependent diabetics, both before and after treatment with pirenzepina (Gastrozepin). The study population included 8 patients, 6 males and 2 females, between the ages of 12 and 17 years, with a mean of 15.6 years. Pirenzepina was administered during one month at a nightly oral dose of 0.6 mg/kg followed by 5 months of treatment with 1 mg/kg. The most important results obtained in the study are the following: 1) Nocturnal administration of pirenzepina did not significantly modify the MNGH in the study population (10.88 +/- 3.81 ng/ml vs 9.57 +/- 8.25 ng/ml, p > 0.05). 2) This pharmaceutical did not alter the plasma levels of HbA1-C (9.57 +/- 8.25 vs 10.01 +/- 2.30, p > 0.05). However, 5 out of 8 patients had a decrease in their nocturnal GH secretion after pirenzepina treatment. If only the 5 patients that responded to this treatment are considered, the differences in MNGH are significant (10.48 +/- 4.94 before treatment vs 4.35 +/- 2.53 following treatment, p < 0.05). Therefore, we conclude that oral pirenzepina treatment for 6 months, at the doses described, do not consistently decrease GH secretion in young diabetics nor does it decrease HbA1-C values in this group. However, further studies are necessary to establish the possible value of this treatment.

[Nocturnal use of pirenzepine by a group of insulin dependent juvenile diabetics]. / Uso de pirenzepina oral nocturna en jóvenes diabéticos insulino-dependientes.

Different studies have shown an elevation of GH levels in insulin-dependent diabetic adults and its modification after pirenzepine administration. We have studied nocturnal GH secretion (NIGHS) and fructosamine levels before and after one month of administering a nocturnal dose of pirenzepine [Gastrozepin (R.) 0.6 mg/kg] in a group of eight young insulin-dependent diabetics, 6 males and 2 females. The ages of the subjects ranged between 12 and 17 years with a mean age of 15.28 years. The most important findings were: 1) The NIGHS was not modified by pirenzepine administration, 10.88 +/- 3.81 ng/ml/min vs 11.25 +/- 7.90 ng/ml/min, p greater than 0.05. However, two patients showed a clear decrease in their G.H. levels. 2) Plasma fructosamine levels were also unaffected, 409 +/- 101 mmol/l vs 361 +/- 127 mmol/l, p greater than 0.05. However, the levels of five individual patients decreased after pirenzepine administration. We conclude that oral pirenzepine administration at this dose does not modify GH secretion nor improve short term metabolic control of the disease in young insulin-dependent diabetics. Further investigation, using higher doses and for a more prolonged period of time, is necessary to know the long term effects of this treatment.