ergoline and Diabetes-Mellitus--Type-2

Dopamine action appears to play a role in changes that are seen in obesity, metabolic syndrome and type 2 diabetes mellitus. Bromocriptine-QR (Quick Release), a dopamine agonist, is approved for use in treatment of type 2 diabetes. It has demonstrated modest improvement in glycemic parameters, cholesterol and weight in certain cohorts. Limited data using cabergoline, a long-acting dopamine agonist, also demonstrate glycemic efficacy. Additionally, bromocriptine-QR appears to have a favorable cardiovascular risk reduction. The direct mechanism by which bromocriptine-QR, or central dopamine agonism, achieves modest glycemic control and favorable cardio-metabolic profile is unclear. This relationship appears to be more complex than the historical explanation of "resetting" the circadian clock and may further be elucidated using data in individuals with hyperprolactinemia and prolactinoma.

Topics: Animals; Biomarkers; Blood Glucose; Bromocriptine; Cabergoline; Cardiovascular Diseases; Comorbidity; Diabetes Mellitus, Type 2; Dopamine Agonists; Ergolines; Humans; Hypoglycemic Agents; Risk Factors; Treatment Outcome

Cabergoline is a long-acting agonist of dopamine, which has a high affinity to dopamine receptors (type 2). Treatment using a dopaminergic agonist reduces hypothalamic stimulation that increases during liver gluconeogenesis, lipids synthesis, and insulin resistance. Our aim was to evaluate the effects of cabergoline on blood glucose levels in patients with type 2 diabetes mellitus (DM).. This study was a double-blind, controlled clinical trial in patients with type 2 DM. The patients received treatments of a placebo (control group; n = 20) or cabergoline 0.5 mg (cabergoline group; n = 20) using the sequential method, once per week for 3 months, while using previously prescribed glucose-lowering drugs. All tests, such as levels of fasting blood glucose, 2-hour post-prandial glucose, complete lipid profile, prolactin, alanine amino transferase, aspartate amino transferase, creatinine, blood urea nitrogen, and serum insulin, and homeostasis model assessment insulin resistance were measured at baseline and at 3-month follow-up.. The fasting blood sugar levels were significantly different between placebo and cabergoline groups after 3 months of treatment (P = 0.004). The prolactin levels were significantly different from beginning of the treatment to 6 months later (P = 0.001). In the cabergoline group, there was a significant decrease in glycosylated hemoglobin (HbA1C) levels after 3 months (P = 0.003). Overall, 65%and 45% patients in the cabergoline and control groups, respectively, responded to treatment (HbA1C<7%).. Cabergoline may be useful as a long-acting antidiabetic agent in patients with type 2 diabetes mellitus.

Topics: Blood Glucose; Cabergoline; Diabetes Mellitus, Type 2; Dopamine Agonists; Double-Blind Method; Ergolines; Female; Glycated Hemoglobin; Humans; Hypoglycemic Agents; Male; Middle Aged

Ergot-derived dopamine D2 receptor agonists are the usual treatment of hyperprolactinemia and Parkinson's disease and recently bromocriptine has been approved for the treatment of type 2 diabetes. The aim of this study was the evaluation of short-term effect of cabergoline in poorly controlled diabetic patients with oral agent failure who refused insulin therapy.. This study was performed in 17 overweight women and men with type 2 diabetes with persistent hyperglycemia in spite of treatment with maximum dose of sulfonylurea, metformin and pioglitazone. 10 patients (group I) randomized to be treated with cabergoline 0.5 mg weekly for 3 months and 7 patients (group II) with placebo. Fasting and postprandial plasma glucose concentration and HbAlc measured in beginning and end of the study.. FBS decreased from 210.70 +/- 21.29 to 144.90 +/- 26.56 mg/dl in cabergoline group whereas it decreased in placebo group insignificantly. Postprandial blood glucose decreased from 264.2 +/- 28 mg/dl to 203.6 +/- 34.34 mg/dl in cabergoline group whereas it increased in placebo group insignificantly. HbA1c decreased in cabergoline group from 8.48 +/- 0.44 to 7.7 +/- 0.11 whereas in control group it increased insignificantly from 8.7 +/- 0.33 to 8.8 +/- 0.16.. Cabergoline improves glycemic control in type 2 diabetic patients with oral agent failure. It reduces both fasting and postprandial plasma glucose levels and causes 0.45-1.11 reduction in HbA1c.

Topics: Adult; Blood Glucose; Cabergoline; Diabetes Mellitus, Type 2; Dopamine Agonists; Ergolines; Female; Glycated Hemoglobin; Humans; Hypoglycemic Agents; Male; Middle Aged; Treatment Failure

Pituitary gigantism, a condition of endogenous growth hormone (GH) hypersecretion prior to epiphyseal closure, is a rare condition. In the adult condition of GH excess, acromegaly, the occurrence of type 2 diabetes mellitus (T2DM) and diabetic ketoacidosis (DKA) have been reported, with resolution following normalization of GH levels. We report the case of a 16-year-old male with pituitary gigantism due to a large invasive suprasellar adenoma who presented with T2DM and DKA. Despite surgical de-bulking, radiotherapy and medical treatment with cabergoline and pegvisomant, GH and insulin-like growth factor-I (IGF-I) levels remained elevated. However, the T2DM and recurrent DKA were successfully managed with metformin and low-dose glargine insulin, respectively. We review the pathophysiology of T2DM and DKA in growth hormone excess and available treatment options.

Topics: Adenoma; Adolescent; Antineoplastic Agents; Cabergoline; Combined Modality Therapy; Diabetes Mellitus, Type 2; Ergolines; Gigantism; Human Growth Hormone; Humans; Hypoglycemic Agents; Insulin; Insulin Glargine; Insulin, Long-Acting; Male; Metformin; Pituitary Neoplasms; Radiotherapy