EFFECTS OF OCTREOTIDE ON GLYCEMIC CONTROL, GLUCOSE DISPOSAL, HEPATIC GLUCOSE-PRODUCTION AND COUNTERREGULATORY HORMONES SECRETION IN TYPE-1 AND TYPE-2 INSULIN-TREATED DIABETIC-PATIENTS

We studied the effects of continuous subcutaneous infusion of octreoti de (100 mu g/day for 5 days) on glycaemic values, counterregulatory ho rmones secretion: hepatic glucose production (HGP) and glucose disposa l during an euglycaemic clamp in 7 C-peptide-negative type 1 diabetic patients and 7 C-peptide positive insulin-treated type 2 diabetic pati ents. In type 1, but not type 2 diabetic patients, octreotide signific antly reduced glycaemic values (P < 0.005) and also diminished HGP dur ing an euglycaemic clamp (P < 0.05). However, insulin stimulated globa l glucose uptake remained unchanged. GH, glucagon, IGF-I, IGFBP-3 leve ls, were significantly lowered by octreotide in both type 1 and type 2 diabetic patients whereas cortisol and epinephrine remained unmodifie d. Moreover in type 2 diabetic patients both basal (P < 0.05) and afte r-meal (P < 0.01) C-peptide secretion was reduced by octreotide. These data point to different metabolic effects of octreotide in type 1 ver sus type 2 diabetic patients with the drug only being able to reduce g lycaemic values and HGP in the former but not in the latter subjects. The failure of octreotide to diminish glycaemic values and HGP in type 2 diabetic patients in spite of its ability to lower GH and glucagron may probably depend on temporary blockage of residual endogenous insu lin secretion induced by octreotide administration. (C) 1997 Elsevier Science Ireland Ltd.