c-peptide and deflazacort

The aim of this study was to compare the effect of nicotinamide (NCT) alone or in combination with a cortisone-like substance, deflazacort (DFL), on the integrated parameters of metabolic control in patients with the recent-onset of insulin-dependent diabetes mellitus (IDDM).. Thirty-six patients who were diagnosed with diabetes between 5 and 35 years of age entered a randomized, double-blind, 1-year prospective study. Group A (n = 18) received NCT for 1 year (25 mg.kg-1.day-1) plus DFL for 3 months (0.6 mg.kg-1.day-1 in the first month, 0.3 mg.kg-1.day-1 in the other 2 months). Group B (n = 18) received NCT for 1 year (25 mg.kg-1.day-1) plus placebo for the first 3 months. All patients were treated with intensified insulin therapy.. At 3 months after diagnosis, the insulin dose was significantly higher in group A compared with group B (P < 0.03) with similar HbA1 levels. Basal and stimulated C-peptide levels in group A of both adults and children were significantly higher compared with patients of group B (P < 0.05 and P < 0.03, respectively). At the end of a 1-year follow-up, basal C-peptide did not differ between the two groups, although stimulated C-peptide was still significantly higher in patients of group A compared with group B (P < 0.05). Finally, insulin requirement did not differ between the two groups.. A short-term course of DFL therapy at diagnosis in addition to NCT slightly increases glucagon-stimulated but not basal beta-cell function after 1 year.

Topics: Adolescent; Adult; Age Factors; Anti-Inflammatory Agents; C-Peptide; Child; Child, Preschool; Diabetes Mellitus, Type 1; Drug Therapy, Combination; Female; Follow-Up Studies; Glucagon; Glycated Hemoglobin; Humans; Insulin; Male; Niacinamide; Pregnenediones

Glucocorticoid-induced glucose intolerance has been related to the dose, duration of treatment, and steroid compound. However, a clear demonstration of this phenomenon is still lacking for fluorinated corticosteroids. We performed an oral glucose tolerance test in six healthy volunteers after the short-term administration of deflazacort (18 + 18 mg), prednisone (15 + 15 mg), and betamethasone disodium phosphate (1.5 + 1.5 mg) at equivalent anti-inflammatory doses, in random sequence, and in a triple crossover design. Fasting plasma glucose levels were not modified by deflazacort, whereas fasting plasma glucose levels together with insulin and C-peptide values were progressively and significantly increased by prednisone and betamethasone. During oral glucose tolerance testing a significant increase in the plasma glucose and insulin peaks was recorded after betamethasone and, to a lesser extent, after prednisone and deflazacort. These results suggest that betamethasone induces greater glucose intolerance and insulin resistance than prednisone and deflazacort.

Topics: Adult; Betamethasone; Blood Glucose; C-Peptide; Double-Blind Method; Female; Glucocorticoids; Glucose Tolerance Test; Humans; Insulin; Male; Prednisone; Pregnenediones; Reference Values