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Publications

Journal Article Randomized Controlled Trial Research Support, Non-U.S. Gov't Research Support, N.I.H., Extramural Ppublish 7 citations

PubMed: 35712800 DOI: 10.1111/dom.14800

Bromocriptine quick-release as adjunct therapy in youth and adults with type 1 diabetes: A randomized, placebo-controlled crossover study.

Diabetes Obes Metab 24(11):2148-2158

Authors: Shoshana S Tell, Michal Schafer, Timothy Vigers, Amy D Baumgartner, Ellen Lyon, Susan Gross, Sarit Polsky, Janet K Snell-Bergeon, Irene E Schauer, Kristen J Nadeau

Affiliations

  • Division of Pediatric Endocrinology, Department of Pediatrics, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA.
  • Barbara Davis Center for Childhood Diabetes, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA.
  • Division of Pediatric Cardiology, Department of Pediatrics, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA.
  • Division of Endocrinology and Metabolism, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA.
  • Endocrinology Section, Rocky Mountain Regional VA Medical Center, Aurora, Colorado, USA.

Abstract

AIM

To evaluate the potential for glycaemic, renal and vascular benefits of bromocriptine quick release (BCQR) in adolescents and adults with type 1 diabetes.

MATERIALS AND METHODS

Forty adolescents and 40 adults with type 1 diabetes aged 12-60 years old were enrolled in a double-blind, placebo-controlled, random order crossover study of 4 weeks of treatment in the morning with BCQR (titrated weekly from 0.8 mg to 1.6 mg to 3.2 mg, minimum dose 1.6 mg). Study assessments after each phase included blood pressure (BP), lipids, peripheral arterial stiffness and autonomic function, mixed meal tolerance test, continuous glucose monitoring (CGM), creatinine, estimated glomerular filtration rate, estimated insulin sensitivity, insulin dose and indirect calorimetry.

RESULTS

Adolescents displayed baseline hyperglycaemia, insulin resistance, metabolic dysfunction and increased renal filtration compared with adults. In both age groups, continuous glucose monitoring measures, estimated insulin sensitivity and insulin dose did not differ with BCQR treatment. In adolescents, BCQR decreased systolic BP, diastolic BP and triangular index and increased serum creatinine. In adults, systolic BP, mean arterial pressure, systemic vascular resistance, and mixed meal tolerance test glucose and glucagon-like peptide 1 areas under the curve were lower, and the orthostatic drop in systolic BP was greater with BCQR.

CONCLUSIONS

Greater hyperglycaemia, insulin resistance, metabolic dysfunction and renal hyperfiltration in adolescents argues for increased attention during this high-risk age period. Although BCQR had little impact on glycaemia or insulin sensitivity, initial vascular and renal responses suggest potential benefits of BCQR in adolescents and adults with type 1 diabetes requiring further study.

MeSH

Diabetes Mellitus, Creatinine, Insulin Resistance, Insulin, Bromocriptine, Cross-Over Studies, Adolescent, Therapeutics, Meals, Diabetes Mellitus, Type 1, Continuous Glucose Monitoring

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