{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T14:17:48Z","timestamp":1784557068196,"version":"3.55.0"},"reference-count":10,"publisher":"Bioscientifica","issue":"2","license":[{"start":{"date-parts":[[2023,4,1]],"date-time":"2023-04-01T00:00:00Z","timestamp":1680307200000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["edm.bioscientifica.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2023,4,1]]},"abstract":"\n Summary<\/jats:title>\n Multiple research studies address the anti-insulinemic effect of growth hormone (GH). We report a case of a patient with anterior hypopituitarism on GH replacement who later developed type 1 diabetes mellitus (T1DM). Recombinant human growth hormone (rhGH) therapy was discontinued at the time of growth completion. Because of significantly improved glycemic control, this patient was weaned off subcutaneous insulin. He regressed from stage 3 to stage 2 T1DM and remained in this status for at least 2 years and until the writing of this paper. The diagnosis of T1DM was established based on relatively low C-peptide and insulin levels for the degree of hyperglycemia as well as seropositivity of zinc transporter antibody and islet antigen-2 antibody. Additional laboratory data obtained 2 months after discontinuing rhGH revealed improved endogenous insulin secretion. This case report calls attention to the diabetogenic effect of GH therapy in the setting of T1DM. It also demonstrates the possibility of regression from stage 3 T1DM requiring insulin therapy to stage 2 T1DM with asymptomatic dysglycemia after discontinuing rhGH.<\/jats:p>\n <\/jats:sec>\n \n Learning points<\/jats:title>\n \n \n Given the diabetogenic effect of growth hormone, blood glucose levels should be monitored in patients with type 1 diabetes mellitus (T1DM) on insulin therapy and recombinant human growth hormone (rhGH) replacement.<\/jats:p>\n <\/jats:list-item>\n \n Clinicians should closely monitor for risk of hypoglycemia after discontinuing rhGH among T1DM patients who are on insulin treatment.<\/jats:p>\n <\/jats:list-item>\n \n The discontinuation of rhGH in the setting of T1DM may cause regression of symptomatic T1DM to asymptomatic dysglycemia requiring no insulin treatment.<\/jats:p>\n <\/jats:list-item>\n <\/jats:list>\n <\/jats:sec>","DOI":"10.1530\/edm-22-0276","type":"journal-article","created":{"date-parts":[[2023,5,16]],"date-time":"2023-05-16T13:07:47Z","timestamp":1684242467000},"update-policy":"https:\/\/doi.org\/10.1530\/crossmarkpolicy-2","source":"Crossref","is-referenced-by-count":1,"title":["Regression from stage 3 to stage 2 type 1 diabetes mellitus after discontinuing growth hormone therapy"],"prefix":"10.1530","volume":"2023","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9664-8826","authenticated-orcid":true,"given":"Micah A","family":"Fischer","sequence":"first","affiliation":[{"name":"Department of Pediatrics, University of Nebraska Medical Center, Children\u2019s Hospital and Medical Center, Omaha, Nebraska, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ghada A","family":"Elmahmudi","sequence":"additional","affiliation":[{"name":"Department of Holland Regenerative Medicine Program, University of Nebraska Medical Center, Omaha, Nebraska, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bracha K","family":"Goldsweig","sequence":"additional","affiliation":[{"name":"Division of Pediatric Endocrinology, University of Nebraska Medical Center, Children\u2019s Hospital and Medical Center, Omaha, Nebraska, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Salaheddin H","family":"Elrokhsi","sequence":"additional","affiliation":[{"name":"Division of Pediatric Endocrinology, University of Nebraska Medical Center, Children\u2019s Hospital and Medical Center, Omaha, Nebraska, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"416","reference":[{"key":"bib1","series-title":"Diabetes Care","first-page":"1964","article-title":"Staging presymptomatic type 1 diabetes: a scientific statement of JDRF, the Endocrine Society, and the American Diabetes Association","volume":"38","author":"Insel","year":"2015","unstructured":"Insel RADunne JLAtkinson MAChiang JLDabelea DGottlieb PAGreenbaum CJHerold KCKrischer JPLernmark \u00c5, Staging presymptomatic type 1 diabetes: a scientific statement of JDRF, the Endocrine Society, and the American Diabetes Association. Diabetes Care2015381964\u20131974. (https:\/\/doi.org\/10.2337\/dc15-1419)"},{"key":"bib2","series-title":"BMJ","first-page":"897","article-title":"\"Growth\" and the diabetogenic action of anterior pituitary preparations","volume":"2","author":"Young","year":"1941","unstructured":"Young FG. \"Growth\" and the diabetogenic action of anterior pituitary preparations. BMJ19412897\u2013901. (https:\/\/doi.org\/10.1136\/bmj.2.4225.897)"},{"key":"bib3","series-title":"Molecular and Cellular Endocrinology","first-page":"111038","article-title":"Effect of growth hormone on insulin signaling","volume":"518","author":"Sharma","year":"2020","unstructured":"Sharma RKopchick JJPuri V & Sharma VM. Effect of growth hormone on insulin signaling. Molecular and Cellular Endocrinology2020518111038. (https:\/\/doi.org\/10.1016\/j.mce.2020.111038)"},{"key":"bib4","series-title":"Lancet","first-page":"610","article-title":"Incidence of diabetes mellitus and impaired glucose tolerance in children and adolescents receiving growth-hormone treatment","volume":"355","author":"Cutfield","year":"2000","unstructured":"Cutfield WSWilton PBennmarker HAlbertsson-Wikland KChatelain PRanke MB & Price DA. Incidence of diabetes mellitus and impaired glucose tolerance in children and adolescents receiving growth-hormone treatment. Lancet2000355610\u2013613. (https:\/\/doi.org\/10.1016\/S0140-6736(9904055-6)"},{"key":"bib5","series-title":"Journal of Pediatrics","first-page":"10","article-title":"Metabolic safety of growth hormone in type 1 diabetes and idiopathic growth hormone deficiency","volume":"163","author":"Bonfig","year":"2013","unstructured":"Bonfig WMolz KWoelfle JHofer SEHauffa BPSchoenau EGolembowski SWudy SA & Holl RW. 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PNAS2013110E4619\u2013E4627. (https:\/\/doi.org\/10.1073\/pnas.1314985110)"},{"key":"bib8","series-title":"Journal of Pediatric Endocrinology and Metabolism","first-page":"541","article-title":"Development of diabetes mellitus in two boys after the initiation of growth hormone therapy","volume":"20","author":"Sadeghi-Nejad","year":"2007","unstructured":"Sadeghi-Nejad A. Development of diabetes mellitus in two boys after the initiation of growth hormone therapy. Journal of Pediatric Endocrinology and Metabolism200720541\u2013544. (https:\/\/doi.org\/10.1515\/jpem.2007.20.4.541)"},{"key":"bib9","series-title":"International Journal of Clinical and Experimental Medicine","first-page":"8243","article-title":"Recombinant human growth hormone in treatment of diabetes: report of three cases and review of relative literature","volume":"8","author":"Wang","year":"2015","unstructured":"Wang DZhao N & Zhu Z. 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