RSS Feeds
Risks and Benefits of Insulin-like Growth Factor
- Monica Skarulis, MD; and
- Carolyn Bondy, MD
The Editors welcome submissions for possible publication in the Letters section. Authors of letters should:
•Include no more than 300 words of text, three authors, and five references
•Type with double-spacing
•Send three copies of the letter, an authors' form signed by all authors, and a cover letter describing any conflicts of interest related to the contents of the letter.
Letters commenting on an Annals article will be considered if they are received within 6 weeks of the time the article was published. Only some of the letters received can be published. Published letters are edited and may be shortened; tables and figures are included only selectively. Authors will be notified that the letter has been received. If the letter is selected for publication, the author will be notified about 3 weeks before the publication date. Unpublished letters cannot be returned.
Annals welcomes electronically submitted letters.
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.
Monica Skarulis, MD
National Institute of Diabetes and Digestive and Kidney Diseases; Bethesda, MD 20892
Carolyn Bondy, MD
National Institute of Child Health and Human Development; Bethesda, MD 20892
- Copyright ©2004 by the American College of Physicians
