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Effect of a new long-acting somatostatin analogue (SMS 201–995) on glycemic and hormonal response to a mixed meal in acromegalic patients

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Abstract

We investigated in 6 acromegalic patients the acute effects on glucose tolerance and insulin secretion of a single sc injection of the somatostatin analogue SMS 201–995, performed 4 h before a mixed meal with xylose administration. Growth hormone levels decreased from 34.0 ± 20.3 (mean ± SE) to a minimum of 9.3 ± 3.0 ng/ml, 3½ h after the injection. A significant inhibition of insulin secretion was also noticed, with a fall from 25.3 ± 6.4 to 6.3 ± 2.3 μU/ml at 1 h, and a lower and delayed peak level after the mixed meal. However, the postprandial plasma glucose increase was not different from a control day, while plasma xylose levels were lower. Mean glucagon level after SMS 201–995 was lower than control value in 3 out of the 4 patients in whom it was determined. The decrease of serum growth hormone levels, together with partial glucagon inhibition and, more important, a slowing of intestinal absorptive processes, counterbalanced the inhibitory action of SMS 201–995 on insulin secretion, and no deterioration in carbohydrate tolerance could be demonstrated. However, before SMS 201–995 is employed in the management of acromegalic patients refractory to surgery and bromocriptine therapy, we need further observations of postprandial glycemic profiles during long-term therapy with multiple daily injections of the compound.

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References

  1. Hall R., Besser G.M., Shally A.V., Coy D.H., Evered D., Goldie D.J., Kastin A.J., McNeilly A.S., Mortimer C.H., Phenekos C., Tunbridge W.M.G., Weightman D. Action of growth-hormone-release inhibitory hormone in healthy men and in acromegaly. Lancet 2: 581, 1973.

    Article  PubMed  CAS  Google Scholar 

  2. Yen S.S.C., Siler T.M., DeVane G.W. Effect of somatostatin in patients with acromegaly: suppression of growth hormone prolactin, insulin and glucose levels. N. Engl. J. Med. 290: 935, 1974.

    Article  PubMed  CAS  Google Scholar 

  3. Besser G.M., Mortimer C.H., Carr D., Schally A.V., Coy D.H., Evered D., Kastin A.J., Tunbridge W.M.G., Thorner M.O., Hall R. Growth hormone release inhibiting hormone in acromegaly. Br. Med. J. 1: 352, 1974.

    Article  PubMed Central  PubMed  CAS  Google Scholar 

  4. Brazeau O., Vale W., Burgus R., Ling N., Rivier J., Guillemin R. Hypothalamic polypeptide that inhibits the secretion of immunoreactive pituitary growth hormone. Science 179: 77, 1973.

    Article  PubMed  CAS  Google Scholar 

  5. Reubi J.C., Landolt A.M. High density of somatostatin receptors in pituitary tumors from acromegalic patients. J. Clin. Endocrinol. Metab. 59: 1148, 1984.

    Article  PubMed  CAS  Google Scholar 

  6. Moyse E., Le Dafniet M., Epelbaum J., Pagesy P., Peillon F., Kordon C., Enjalbert A. Somatostatin receptors in human growth hormone and prolactin-secreting pituitary adenomas. J. Clin. Endocrinol. Metab. 61: 98, 1985.

    Article  PubMed  CAS  Google Scholar 

  7. Peracchi M., Reschini E., Cantalamessa L., Giustina G., Cavagnini F., Pinto M., Bulgheroni P. Effect of somatostatin on blood glucose, plasma growth hormone, insulin and free fatty acids in normal subjects and acromegalic patients. Metabolism 23: 1009, 1974.

    Article  PubMed  CAS  Google Scholar 

  8. Giustina G., Peracchi M., Reschini E., Panerai A.E., Pinto M. Dose-response study of the inhibitingeffect of somatostatin on growth hormone and insulin secretion in normal subjects and acromegalic patients. Metabolism 24: 807, 1975.

    Article  PubMed  CAS  Google Scholar 

  9. Dunn P.J., Donald R.A., Espiner E.A. A comparison of the effect of levodopa and somatostatin on the plasma levels of growth hormone, insulin, glucagon and prolactin in acromegaly. Clin. Endocrinol. (Oxf.) 5: 167, 1976.

    Article  CAS  Google Scholar 

  10. Bauer W., Briner U., Doepfner W., Haller R., Huguenin R., Marbach P., Petcher T.J., Pless J. SMS 201–995: a very potent and selective octapeptide analogue of somatostatin with prolonged action. Life Sci. 31: 1133, 1982.

    Article  PubMed  CAS  Google Scholar 

  11. Plewe G., Beyer J., Krause U., Neufeld M., Del Pozo E. Long-acting and selective suppression of growth hormone secretion by somatostatin analogue SMS 201–995 in acromegaly. Lancet 2: 782, 1984.

    Article  PubMed  CAS  Google Scholar 

  12. Lamberts S.W.J., Oosterom R., Neufeld M., Del Pozo E. The somatostatin analog SMS 201–995 induces long-acting inhibition of growth hormone secretion without rebound hypersecretion in acromegalic patients. J. Clin. Endocrinol. Metab. 60: 1161, 1985.

    Article  PubMed  CAS  Google Scholar 

  13. Lamberts S.W.J., Uitterlinden P., Verschoor L., Van Dongen K.J., Del Pozo E. Long-term treatment of acromegaly with the somatostatin analogue SMS 201–995. N. Engl. J. Med. 313: 1576, 1985.

    Article  PubMed  CAS  Google Scholar 

  14. Ch’ng L.J.C, Sandler L.M., Kraenzlin M.E., Burrin J.M., Joplin G.F., Bloom S.R. Long term treatment of acromegaly with a long acting analogue of somatostatin. Br. Med. J. 290: 284, 1985.

    Article  Google Scholar 

  15. Tolis G., Yotis A., Del Pozo E., Pitoulis S. Therapeutic efficacy of a somatostatin analogue (SMS 201–995) in active acromegaly. J. Neurosurg. 65: 37, 1986.

    Article  PubMed  CAS  Google Scholar 

  16. Williams G., Ball J.A., Burrin J.M., Joplin G.F., Bloom S.R. Effective and lasting growth-hormone suppression in active acromegaly with oral administration of somatostatin analogue SMS 201–995. Lancet 2: 774, 1986.

    Article  PubMed  CAS  Google Scholar 

  17. Barnard L.B., Grantham W.G., Lamberton P., O’Dorisio T.M., Jackson I.M.D. Treatment of resistant acromegaly with a long-acting somatostatin analogue (SMS 201–995). Ann. Intern. Med. 105: 856, 1986.

    Article  PubMed  CAS  Google Scholar 

  18. Sandler L.M., Burrin J.M., Williams G., Joplin G.F., Carr D.H., Bloom S.R. Effective long-term treatment of acromegaly with a long-acting somatostatin analqgue (SMS 201–995). Clin. Endocrinol. (Oxf.) 26: 85, 1987.

    Article  CAS  Google Scholar 

  19. Doughaday W.H. A new treatment for an old disease. N. Engl. J. Med. 23: 1604, 1985.

    Article  Google Scholar 

  20. Roe J.H., Rice E.W. Photometric determination of free pentoses in animal tissues. J. Biol. Chem. 173: 507, 1948.

    PubMed  CAS  Google Scholar 

  21. Roelfsema F., Van Dulken H., Frölich M. Long-term results of transsphenoidal pituitary microsurgery in 60 acromegalic patients. Clin. Endocrinol. (Oxf.) 23: 555, 1985.

    Article  CAS  Google Scholar 

  22. Quabbe H.J. Treatment of acromegaly by trans-sphenoidal operation, 90-yttrium implantation and bromocriptine: results in 230 patients. Clin. Endocrinol. (Oxf.) 16: 107, 1982.

    Article  CAS  Google Scholar 

  23. Nabarro J.D.N. Acromegaly. Clin. Endocrinol. (Oxf.) 26: 481, 1987.

    Article  CAS  Google Scholar 

  24. Feek C.M., McLelland J., Seth J., Toft A.D., Irvine W.J., Padfield P.L., Edwards C.R.W. How effective is external pituitary irradiation for growth hormone-secreting pituitary tumors? Clin. Endocrinol. (Oxf.) 20: 401, 1984.

    Article  CAS  Google Scholar 

  25. Cantalamessa L., Catania A., Baldini M., Orsatti A. Improvement of diabetes after treatment with somatostatin analogue SMS 201–995 in an acromegalic patient. Horm. Metab. Res. 18: 790, 1986.

    Article  PubMed  CAS  Google Scholar 

  26. Lamberts S.W.J., Del Pozo E. Long-term treatment of acromegaly with the somatostatin analogue SMS 201–995. N. Engl. J. Med. 314: 1391, 1986.

    Google Scholar 

  27. Roelfsema F., Frölich M. Glucose tolerance and plasma immunoreactive insulin levels in acromegalics before and after selective transsphenoidal surgery. Clin. Endocrinol. (Oxf.) 22: 531, 1985.

    Article  CAS  Google Scholar 

  28. Spinas G.A., Bock A., Keller U. Reduced postprandial hyperglycemia after subcutaneous injection of a somatostatin analogue (SMS 201–995) in insulin-dependent diabetes mellitus. Diabetes Care 8: 429, 1985.

    Article  PubMed  CAS  Google Scholar 

  29. Serrano Rios M., Navascues I., Saban J., Ordoñez A., Sevilla F., Del Pozo E. Somatostatin analog SMS 201–995 and insulin needs in insulin-dependent diabetic patients studied by means of an artificial pancreas. J. Clin. Endocrinol. Metab. 63: 1071, 1986.

    Article  Google Scholar 

  30. Candrina R., Coppini A., Rotondi A., Giustina G. Effects of a new long-acting somatostatin analogue (SMS 201–995) on glycemic and hormonal profiles in insulin-treated type II diabetic patients. J. Endocrinol. Invest. (submitted).

  31. Davies R.R., Miller M., Turner S.J., Goodship T.H.J., Cook D.B., Watson M., McGill A., Ørskov H., Alberti K.G.M.M., Johnston D.G. Effects of somatostatin analogue SMS 201–995 in normal man. Clin. Endocrinol. (Oxf.) 24: 665, 1986.

    Article  CAS  Google Scholar 

  32. Wood S.M., Kraenzlin M.E., Adrian T.E., Bloom S.R. Treatment of patients with pancreatic endocrine tumours using a new long-acting somatostatin analogue; symptomatic and peptide response. Gut 26: 438, 1985.

    Article  PubMed Central  PubMed  CAS  Google Scholar 

  33. Williams N.S., Cooper J.C., Axon A.T.R., King R.F.G.J., Barker M. Use of a long acting somatostatin analogue in controlling life threatening diarrhoea. Br. Med. J. 289: 1027, 1984.

    Article  CAS  Google Scholar 

  34. Plewe G., Nölken G., Schrezenmeir J., Krause U., Beyer J., Kasper H. Long-term treatment of acromegaly with the somatostatin analogue SMS 201–995. N. Engl. J. Med. 374: 1390, 1986.

    Google Scholar 

  35. Wahren J., Felig P. Influence of somatostatin on carbohydrate disposal and absorption in diabetes mellitus. Lancet 2: 1213, 1976.

    Article  PubMed  CAS  Google Scholar 

  36. Candrina R., Coppini A., Graffeo M., Zuccato F., Giustina G. SMS 201–995 improves glucose tolerance in insulin-treated type II diabetic patients. Diabetes Care 10: 534, 1987.

    PubMed  CAS  Google Scholar 

  37. Candrina R., Giustina G. Somatostatin analogue SMS 201–995 in non-insulin-dependent diabetes. Clin. Endocrinol. (Oxf.), in press.

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Authors and Affiliations

  1. Istituto di Patologia Medica, Università di Brescia, 2a Medicina, Spedali Civili, 25100, Brescia, Italy

    Renato Candrina & G. Giustina

  2. 3° Laboratorio Analisi, Spedali Civili, 25100, Brescia, Italy

    A. Gussago

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  1. Renato Candrina
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  2. A. Gussago
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  3. G. Giustina
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Candrina, R., Gussago, A. & Giustina, G. Effect of a new long-acting somatostatin analogue (SMS 201–995) on glycemic and hormonal response to a mixed meal in acromegalic patients. J Endocrinol Invest 11, 21–26 (1988). https://doi.org/10.1007/BF03350089

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