Hepatic Growth Hormone Resistance in Young Women with Type 1 Diabetes: Comparison with controls and effects of oral and transdermal estrogen administration (EsTiD study)
Study code
CBR086
Lead researcher
Dr David Dunger
Study type
Participant re-contact
Institution or company
University of Cambridge, the MRC, NHSBT, Cambridge Biomedical Research Centre
Researcher type
Academic
Speciality area
Diabetes
Summary
Type 1 diabetes (T1D) is characterised by increased growth hormone (GH) and reduced insulin-like growth factor-I (IGF-I) levels due to relative portal insulinopaenia. These hormonal aberrations are associated with lower insulin sensitivity, which is particularly marked during puberty and in young adults. Moreover, patients with the lowest IGF-I levels appear to have the highest risk for the development of microalbuminuria.
Regular oral oestrogen intake, e.g., as part of the contraceptive pill, may be an additional risk factor for developing microalbuminuria. Extensive first pass metabolism and an exacerbation of the changes in GH and IGF-I levels may be the underlying mechanisms. These observations have not been tested in a physiological study of humans with T1D.
This study aims to measure hepatic IGF-1 generation in women with T1D versus healthy female controls and to determine the effect of oral versus transdermal oestrogen on IGF-1 generation, urine albumin excretion and biomarkers for cardiovascular risk.