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      Growth Hormone Treatment of Children with Prader-Willi Syndrome: Effects on Glucose and Insulin Homeostasis

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          Insulin and glucose homeostasis have been studied during growth hormone (GH) treatment in 19 prepubertal children with Prader-Willi syndrome (PWS) and compared with 11 healthy prepubertal obese children. Before treatment, insulin levels in children with PWS were lower (p < 0.01) than in healthy obese children. During GH treatment, fasting insulin levels increased in children with PWS (p < 0.001). Glucose levels were similar for PWS and obese children before treatment. Children with PWS showed a slow glucose disappearance rate (k = 1.7%) which deteriorated (k = 1.3%, p < 0.001) during GH treatment. HbA1c and fasting glucose levels remained normal. Thus, GH treatment of children with PWS resulted in increased insulin blood levels, unchanged fasting glucose and HbA1c but decreased glucose elimination rate after an intravenous glucose test. However, the observed dose-dependent increase in insulin levels during GH treatment, that reached supranormal concentrations in 6/19 patients, and the occurrence of NIDDM in 1 patient during follow-up suggest that close surveillance and low doses of GH should be applied, especially if the PWS patient is very obese.

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          Author and article information

          Horm Res Paediatr
          Hormone Research in Paediatrics
          S. Karger AG
          April 1999
          27 August 1999
          : 51
          : 4
          : 157-161
          Department of Woman and Child Health, Pediatric Endocrinology Unit, Karolinska Hospital, Stockholm, Sweden
          23350 Horm Res 1999;51:157–161
          © 1999 S. Karger AG, Basel

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          Page count
          Figures: 2, Tables: 1, References: 23, Pages: 5
          Original Paper


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