Impaired insulin action in puberty. A contributing factor to poor glycemic control in adolescents with diabetes.

摘要: Patients with insulin-dependent diabetes mellitus often have poor metabolic control during puberty. To determine whether puberty is associated decreased insulin-stimulated glucose metabolism, we compared the results of euglycemic insulin-clamp studies in adults and prepubertal pubertal children without diabetes. In nondiabetic children, metabolism (201 +/- 12 mg per square meter body surface area minute) was sharply reduced, as that (316 34 290 21 meter, respectively; P less than 0.01), despite comparable hyperinsulinemia (insulin levels 80 to 90 microU milliliter). Similarly, response insulin 25 30 percent lower diabetic (P 0.05) = 0.07). At each stage development, stimulating effect on by 33 42 0.01). all groups studied, inversely correlated mean 24-hour growth hormone (r -0.52, Among glycosylated hemoglobin were substantially higher 0.02), although daily doses tended be higher. These data suggest resistance occurs both normal The combined adverse effects action may help explain why glycemia so difficult achieve adolescent patients.