[Vitreous fluorophotometry and nocturnal GH secretion in young insulin-dependent diabetics treated with oral pirenzepine]. / Fluorofotometría vítrea y secreción nocturna de G.H. en jóvenes diabéticos insulino-dependientes tratados con pirenzepina oral.

With the aim of finding a correlation between the blocking of G.H. secretion and the irregularities in the permeability of the hematoretinal barrier, we have studied the average nocturnal G.H. levels (NAGHL) and the vitreous penetration rate (VPR) in five young diabetic patients. These patients, 3 males and 2 females, were between the ages of 12 and 17 years with a mean age of 16.0. They were studies both before and after receiving treatment for one month with an oral nocturnal dose of 0.6 mg/kg of pirenzepine (gastrozepin) and 1 mg/kg during the subsequent five months. We also tried to find a relationship between the VPR post-treatment and the evolution time of their illness and with their BA1C. The most important results found in this study were: 1) the nocturnal oral pirenzepine modified the NAGHL in the study population (10.48 +/- 4.94 vs; 4.34 +/- 2.53 ng/ml; p < 0.05). 2) Ingestion of the aforementioned drug did not affect the VPR (4.84 +/- 2.08 vs 4.53 +/- 2.54 x 10(-6)/min; p > 0.05). We have not found a relationship between the VPR after treatment with either the HBA1C levels or with the evolution time of the illness. Therefore, we conclude that the dose of oral pirenzepine used for 6 months, although it definitely decreases G.H. secretion, does not modify the permeability of the B.H.R. within this group of young diabetics. Hence, we can infer that the G.H. hypersecretion does not seem to have a relationship, at least exclusively, with the development of diabetic retinopathy.

[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.

[Spontaneous and GHRH-induced nocturnal GH secretion in a child population with insulin dependent diabetes mellitus]. / Secreción de G. H. nocturna espontánea y tras GHRH en una población de niños con diabetes mellitus insulino-dependiente.

It has been studied integrated nocturnal secretion of GH after GHRH test in 15 diabetic children and 10 short stature children with normal GH secretion. The most important findings are: 1) The integrated nocturnal secretion of GH was significantly higher in diabetics than in controls (6.27 +/- 3.11 ngrs/ml/min versus 3.06 +/- 1.41 ngrs/ml/min P [symbol; see text] 0.01). 2) After an acute stimulous with GHRH, diabetic population shows an exaggerated secretion of G. H. during the first 90 minutes compared with control population (33.20 +/- 12.41 ngrs/ml/min versus 18.18 +/- 11.09 P [symbol; see text] 0.01). 3) Both higher spontaneous secretion of G. H., and after GHRH test, are independent of metabolic control (mean nocturnal glycemies and HBA1) and evolution time of disease.