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Recombinant Human Insulin-like Growth Factor as a Therapeutic Agent for Severe Insulin Resistance and Type Η Diabetes Mellitus

Recombinant human insulin-like growth factor I (rhIGF-I) shares many physiological properties with its structural homolog insulin. Studies in normal humans have confirmed the hypoglycemic potential of exogenous rhIGF-I and have provided a rationale for the testing of rhIGF-I as a potential therapy in states of severe insulin resistance and in type Π diabetes mellitus. These studies have demonstrated that rhIGF-I can improve hyperglycemia, hyperinsulinemia and insulin sensitivity in subjects with severe insulin resistance and that it can improve glycemic control and insulin sensitivity in patients with type II diabetes mellitus. Data are accruing that rhIGF-I can also improve hypertriglyceridemia associated with these insulin resistant states. While early studies have revealed significant side effects of rhIGF-I at doses greater than 90 μg/kg b.i.d., more recent preliminary data suggest that efficacious doses with good patient tolerance can be identified.