Role of Growth Hormone Antagonism in Modulating Insulin Sensitivity in Subjects With Pre-diabetes
| Status: | Active, not recruiting |
|---|---|
| Conditions: | Endocrine, Endocrine, Diabetes |
| Therapuetic Areas: | Endocrinology |
| Healthy: | No |
| Age Range: | 18 - 80 |
| Updated: | 4/21/2016 |
| Start Date: | January 2014 |
| End Date: | December 2015 |
Role of Growth Hormone Antagonism in Modulating Insulin Sensitivity in Subjects With Insulin Resistance But Without Diabetes
Growth hormone is well known to cause changes in glucose regulation. People with Laron
syndrome are born without the growth hormone receptor and are protected from diabetes. Mice
who are engineered without the growth hormone receptor are similarly protected from
diabetes. Conversely, people who have excessive amounts of growth hormone, such as patients
with acromegaly, have an increased risk for type 2 diabetes. In acromegaly patients,
treatment with pegvisomant, a medication that reduces insulin like growth factor-1 by
blocking the growth hormone receptor, significantly improves insulin resistance. Pegvisomant
has not been explored as a possibility for the treatment of type 2 diabetes or insulin
resistance in people without acromegaly. In this study, the investigators hope to study the
metabolic effects of pegvisomant on people who have insulin resistance but not diabetes.
Pegivosmant is expected to improve insulin resistance in the liver, fat and muscle as well
as decrease serum free fatty acids.
syndrome are born without the growth hormone receptor and are protected from diabetes. Mice
who are engineered without the growth hormone receptor are similarly protected from
diabetes. Conversely, people who have excessive amounts of growth hormone, such as patients
with acromegaly, have an increased risk for type 2 diabetes. In acromegaly patients,
treatment with pegvisomant, a medication that reduces insulin like growth factor-1 by
blocking the growth hormone receptor, significantly improves insulin resistance. Pegvisomant
has not been explored as a possibility for the treatment of type 2 diabetes or insulin
resistance in people without acromegaly. In this study, the investigators hope to study the
metabolic effects of pegvisomant on people who have insulin resistance but not diabetes.
Pegivosmant is expected to improve insulin resistance in the liver, fat and muscle as well
as decrease serum free fatty acids.
Inclusion Criteria:
- BMI between 18-35
- Homeostatic model assessment - insulin resistance (HOMA-IR) >2.77
- Able to administer daily subcutaneous injections of pegvisomant
Exclusion Criteria:
- Pregnancy
- Breastfeeding in the last 6 months
- Liver function tests greater than 3x the upper limits of normal
- unstable diet over the last 3 months
- unstable weight over the last 6 months
- unstable lipid lowering regimen
- diabetes - type 1 or type 2
- History of major gastrointestinal surgery
- History of pancreatic, liver, biliary, or intestinal disease
- Fasting blood glucose >126
- Fasting triglycerides>300
- A1c>6.5
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