Endocrine Abstracts

It is known that in type 1 diabetes mellitus (T1DM) continuous subcutaneous insulin infusion (CSII) therapy improves metabolic control and reduces risk of hypoglycaemia in comparison with multiple daily injection (MDI). Metabolic outcomes usually considered are HbA1c, BMI, and inflammatory parameters. However few data are available on pituitary and gonadal hormone responses, which are involved in metabolic processes. In order to study the response of anabolic hormones in patients treated with CSII or MDI, we have evaluated IGF1, DHEAS, and testosterone levels in a cohort of T1DM patients, comparing these two different ways of intensive insulin administration. We enrolled 41 patients, aged 19–55 years, 25 males and 16 females; 23 were treated by MDI (group 1) and 18 by CSII (group 2). The groups were similar for age, BMI, and duration of DM. IGF1 was assayed using the electro-chemiluminescent immunoassay (ECLIA) method instead testosterone and DHEAS using the chemiluminescent microparticle immunoassay (CMIA) method. Despite similar glycaemic control (mean±S.D., HbA1c: 8±0.01 in males and 7±0.01 in females of group 1; 7±0.01 both in males and females of group 2), we found in males a significant difference in IGF1 levels (138.8±9.4 in group 1 and 96.2±11.2 ng/ml in group 2, P<0.05) and a not significant trend toward higher DHEAS levels (2912±432.9 and 1909.6±216.9 ng/ml); T levels were higher in females of group 1 than group 2 (1.2±0.8 and 0.5±0.1 ng/ml).

These preliminary data seem to indicate a different hormone response in patients treated by CSII or MDI, with lower stress hormone pattern response for patients on CSII, despite similar glycaemic control. Better ovarian response was observed in women on CSII, with lower androgen production. Further studies are needed to better understand these complex relationships and their prognostic implications.