LETTER
Risks and Benefits of Insulin-like Growth Factor
Monica Skarulis, MD, and
Carolyn Bondy, MD
1 October 1994 | Volume 121 Issue 7 | Pages 549-550
IN RESPONSE:
We are aware of the studies cited by Dr. Burguera on the effects of IGF-I treatment in patients with insulin resistance. However, we did not observe an enhancement in glucose use in the most severely insulin-resistant patients we studied. Furthermore, long-term IGF-I treatment in a patient with compound heterozygous insulin receptor mutations produced only transient, modest improvement in glycemic control. Our observations, which differ from those in the literature cited, are not intended to be generalizable to all patients with insulin resistance but rather to show that in some severely affected patients, resistance to the effects of IGF-I appears to exist.
We are grateful to Dr. Usala for highlighting toxicities associated with high-dose intravenous IGF-I treatment. His experience emphasizes the need to show acceptable short-term and long-term toxicity profiles (in addition to clear benefit) before IGF-I can be considered an important therapy for patients with insulin resistance.
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