Leptin Levels In Patients With Type 1 Diabetes Receiving Intensive Insulin Therapy Compared With Those In Patients Receiving Conventional Insulin Therapy.
Department of Internal Medicine, American University Hospital, New York, NY 10022, USA. [email protected] Several reports suggest that insulin may have a role in the regulation of serum leptin levels, and this is related to the fact that serum leptin levels generally indicate the amount of body fat. Studies show that leptin levels are low in newly diagnosed patients with Type-1 diabetes (T1 DM) and increase after institution of insulin therapy. This study was designed to test whether serum leptin levels are higher in patients receiving intensive insulin therapy (IIT) compared to conventional insulin therapy (CIT). Young patients with T1 DM were studied, 23 on IIT and 23 on CIT. The patients were matched for age (19+/-3 and 20+/-5 yr, respectively), duration of diabetes (8+/-5 and 10+/-6 yr, respectively) and BMI (24+/-4 and 23+/-3 kg/m2, respectively). Leptin levels were higher in IIT compared to CIT (13+/-12 vs 7+/-7 ng/ml, respectively, p<0.05). The results of this study demonstrate that patients on IIT have higher leptin levels than patients on CIT. This increase in leptin level in IIT patients is independent of changes in bw and is probably due to the stimulatory effect of insulin on leptin production. Continue reading >>
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Leptin Levels In Patients With Type 1 Diabetes Receiving Intensive Insulin Therapy Compared With Those In Patients Receiving Conventional Insulin Therapy
, Volume 25, Issue8 , pp 724726 | Cite as Leptin levels in patients with Type 1 diabetes receiving intensive insulin therapy compared with those in patients receiving conventional insulin therapy Several reports suggest that insulin may have a role in the regulation of serum leptin levels, and this is related to the fact that serum leptin levels generally indicate the amount of body fat. Studies show that leptin levels are low in newly diagnosed patients with Type-1 diabetes (T1DM) and increase after institution of insulin therapy. This study was designed to test whether serum leptin levels are higher in patients receiving intensive insulin therapy (IIT) compared to conventional insulin therapy (CIT). Young patients with T1DM were studied, 23 on IIT and 23 on CIT. The patients were matched for age (193 and 205 yr, respectively), duration of diabetes (85 and 106 yr, respectively) and BMI (244 and 233 kg/m2, respectively). Leptin levels were higher in IIT compared to CIT (1312 vs 77 ng/ml, respectively, p<0.05). The results of this study demonstrate that patients on IIT have higher leptin levels than patients on CIT. This increase in leptin level in IIT patients is independent of changes in bw and is probably due to the stimulatory effect of insulin on leptin production. LeptinType 1 diabetesintensive insulin therapyconventional insulin therapy This is a preview of subscription content, log in to check access. Unable to display preview. Download preview PDF. Considine R.V., Sinha M.K., Heiman M.L., et al. Serum immunoreactive leptin concentrations in normal-weight and obese humans. N. Engl. J. Med. 1996, 334: 292295. PubMed CrossRef Google Scholar Ostlund R.E., Yang J.W., Klein S., Gingerich R. Relation between plasma leptin concentration and body fat, gender, diet, age Continue reading >>
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Leptin Aids Type 1 Diabetics
Terminally ill rodents with type 1 diabetes have been restored to full health with a single injection of a substance other than insulin by UT Southwestern Medical Center scientists. Since the discovery of insulin in 1922, type 1 diabetes (insulin-dependent diabetes) in humans has been treated by injecting insulin to lower high blood sugar levels and prevent diabetic coma. New findings by UT Southwestern researchers, which appears in the Proceedings of the National Academy of Sciences, suggest that insulin isnt the only agent that is effective. Leptin, a hormone produced by the bodys fat cells, also lowers blood glucose levels and maintains them in a normal range for extended periods, they found. The fact that these animals dont die and are restored to normal health despite a total lack of insulin is hard for many researchers and clinicians to believe, said Dr. Roger Unger, professor of internal medicine and senior author of the study. Many scientists, including us, thought it would be a waste of time to give leptin in the absence of insulin. Weve been brainwashed into thinking that insulin is the only substance that can correct the consequences of insulin deficiency. The mechanism of leptins glucose-lowering action appears to involve the suppression of glucagon, a hormone produced by the pancreas that raises glucose levels. Normally, glucagon is released when the glucose, or sugar, level in the blood is low. In insulin deficiency, however, glucagon levels are inappropriately high and cause the liver to release excessive amounts of glucose into the bloodstream. This action is opposed by insulin, which tells the bodys cells to remove sugar from the bloodstream. In type 1 diabetes, which affects about 1 million people in the U.S., the pancreatic islet cells that produce i Continue reading >>
Jci -how Does Leptin Restore Euglycemia In Insulin-deficient Diabetes?
Insulin replacement is the cornerstone of type 1 diabetes (T1D) treatment; however, glycemic control remains a challenge. Leptin has been shown to effectively restore euglycemia in rodent models of T1D; however, the mechanism or mechanisms by which leptin exerts glycemic control are unclear. In this issue of the JCI, Perry and colleagues provide evidence that suppression of lipolysis is a key facet of leptin-mediated restoration of euglycemia. However, more work remains to be done to fully understand the antidiabetic mechanisms of leptin. Insulin has long been the therapeutic sine qua non for type 1 diabetes (T1D), where insulin deficiency is the hallmark of the disease. Insulin therapy comes with the risk of inadvertent hypoglycemia, which is the main barrier to tight glycemic control ( 1 ). The demonstration that leptin can restore euglycemia without correcting insulin deficiency in streptozotocin-induced (STZ-induced) rodent models of T1D and thereby replace insulin was baffling and exciting ( 2 4 ). One reason that leptin replacement is effective in this model of T1D is that, in STZ-induced T1D, plasma leptin levels are reduced by more than 80% ( 5 , 6 ). In humans with T1D treated with insulin, plasma leptin levels appear to only decrease by approximately 50% ( 7 , 8 ). It is unclear whether leptin restores euglycemia in humans with T1D, although a trial to evaluate the effects of leptin in T1D patients was completed in 2013 ( ); however, the results of this study have not been made public. A recent study demonstrated that leptin delivery to the brain is sufficient to restore euglycemia in STZ-treated rats ( 5 ), highlighting a key role of the CNS in systemic glucose homeostasis. This work also suggested that this experimental paradigm would allow exploration of t Continue reading >>
Adiponectin And Leptin In Children With Type 1 Diabetes For 3-5 Years With Or Without Residual [beta] Cell Function
Adiponectin and Leptin in Children with Type 1 Diabetes for 3-5 years with or without Residual [beta] cell Function Niels H Birkebka, Jesper S Srensenb, Kurt Kristensnc, Flemming Pociotd & Jan Frystyke Author affiliations View ePoster Download ePoster aDepartment of Pediatrics, Aarhus University Hospital, Aarhus, Denmark; bDepartment of Pediatrics, Randers Hospital, Randers, Denmark; cDepartment of Pediatrics, Aarhus University Hospital, Aarhus, Denmark; dDepartment of Pediatrics, Copenhagen Diabetes Research Center, Herlev, Denmark; eDepartment of Clinical Medicine, Medical Research Laboratory, Aarhus University Hospital, Aarhus, Denmark Background: Studies in adults with type 1 diabetes (T1D) have indicated that adiponectin is negatively associated and leptin positively associated with measures of a residual beta cell function (RBF). Objective and hypotheses: To compare serum adiponectin and leptin levels and their ratio in children with T1D for 35 years with and without RBF and in healthy children. Method: We included 342 children (173 females) with T1D, hereof 136 pre-pubertal children (15 with stimulated C-peptide above 100 pM (RBF+)) and 206 pubertal children (hereof 42 RBF+). Seventy (40 females) healthy children, hereof 40 pre-pubertal served as controls. RBF was evaluated by meal-stimulated C-peptide. We performed multiple linear regression analyses to test for differences in adiponectin, leptin and leptin/adiponectin ratio between patients (+RBF/RBF) and healthy controls, adjusting for age, gender, BMI-SDS and HbA1c, stratified by pubertal status. Results: In prepubertal children leptin and the leptin/adiponectin ratio were higher in RBF+ patients compared with RBF- patients and controls (all P-values <0.04). There was a trend towards elevated adiponectin lev Continue reading >>
Serum Leptin Levels In Type 1 Diabetic And Obese Children: Relation To Insulin Levels.
Serum leptin levels in type 1 diabetic and obese children: relation to insulin levels. Clinical Biochemistry [01 Aug 2000, 33(6):475-480] OBJECTIVES: To compare serum leptin levels in type 1 diabetic and obese children. DESIGN AND METHODS: We studied serum leptin levels in 35 type 1 diabetic, 32 obese, and 35 healthy children. Seven of 35 were new-onset diabetics with ketoacidosis. C-peptide (CPE) levels were used for estimating insulin secretion. RESULTS: Serum leptin levels were lower in diabetics than in controls (p<0.001). Obese children had higher leptin and CPE levels than diabetics and controls. In new-onset diabetics, 1 month insulin treatment did not cause any change in leptin levels (p>0.05). Leptin was correlated positively with body mass index and CPE (p<0.001) and inversely with glucose (p = 0.001) and HbA1c (p<0.05) in the combined group. HbA1c and gender were the independent predictors of leptin in diabetic children (p<0.01). CONCLUSIONS: Low serum leptin levels in type 1 diabetic children may be due to chronic insulin deficiency related with their metabolic control. Leptin and insulin may have complementary roles in maintaining a stable body weight. Continue reading >>
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Leptin For Type 1 Diabetes: Coming Onto Stage To Be (or Not?)
Leptin for type 1 diabetes: Coming onto stage to be (or not?) Article Literature Review in Pediatric Diabetes 13(1):68-73September 2011 with 6 Reads DOI: 10.1111/j.1399-5448.2011.00797.x Source: PubMed The discovery of the adipocyte hormone leptin completely changed our view of energy metabolism. In addition, the discovery of leptin rapidly progressed to clinical development. After a decade of clinical studies, leptin appears not to be the magic bullet therapy for obesity; however, it has a robust role in rare human conditions characterized by its deficiency. Recent exciting work from the Unger laboratory suggests that leptin therapy may also have a potential role for the treatment of Type 1 diabetes. In this review we discuss the positive evidence why such an approach is worthwhile. In order to achieve this broad goal, we reviewed available literature and provided our interpretation of the evidence presented in the original research papers. The potential cautionary aspects of this novel approach will be discussed in an accompanying article. Do you want to read the rest of this article? ... Indeed, Oral (2012) summarized the basic and clinical data that provide support to exploration of administration of recombinant leptin as an adjunctive therapy for patients suffering from type 1 diabetes. For example, leptin replacement can reduce the number of insulin injections as well as the total daily insulin dose required for patients with type 1 diabetes ( ). Moreover, leptin replacement can suppress glucagon levels and hyperglucagonaemia is a hallmark feature of type 1 diabetes (Oral, 2012). ... Continue reading >>
Leptin Levels In Children With Type 1 Diabetes Mellitus.
Leptin Levels in Children with Type 1 Diabetes Mellitus. Journal of Korean Society of Pediatric Endocrinology 2000;5(1): 93-99. Leptin Levels in Children with Type 1 Diabetes Mellitus. Department of Pediatrics, Seoul National University Children`s Hospital, Seoul, Korea. Leptin is a product of ob gene in adipose tissue.This is a important factor for regulation of body weight, especially body fat mass. So it is interested in correlation of leptin with obesity or various diseases related with obesity, particularly diabetes mellitus. It was demonstrated that leptin level was increased in type 2 diabetes and insulin was associated with increased leptin level. This study is to measure leptin levels in type 1 diabetes without insulin resistance, to validate whether insulin increases leptin level and to investigate correlation of leptin with degree of diabetic control and pubertal progression.METHODS: This study included 114 children(boys; 57, girls; 57) with type 1 diabetes, whose blood samples were taken to measure leptin level using RIA(radioimmunoassay). We observed the correlation of leptin with body mass index, HbA1c, insulin dose, duration of disease, and pubertal degree. Mean values of age, BMI, insulin dose, and HbA1c at the measurement of leptin were 13.0+/-5.04 years-old, 18.9+/-3.5kg/m2, 36U/day, and 8.9+/-2.1%, respectively.Thirty seven children were prepubertal and fifty seven children had pubertal characteristics and the rests were not confirmed. With increment of BMI, serum leptin levels were significantly increased in the all subjects, with the same correlation in pubertal female group, but not in pubertal male. There was a relatively weak correlation(r=0.29) of leptin levels with insulin doses. In prepubertal male, there was a significant positive correlatio Continue reading >>
Drop In Both Insulin And Leptin Needed For Fat Burning To Occur
Drop in both insulin and leptin needed for fat burning to occur Drop in both insulin and leptin needed for fat burning to occur Ketogenic diet improves metabolic syndrome in multiple ways 18 December 2017 Researchers have found that metabolism moves from using glucose to burning fat when there is a drop in both insulin and leptin levels. The study has been led by Gerald I. Shulman, professor of medicine, cellular and molecular physiology, and physiological chemistry at Yale University. The research could point towards improved understanding of how best to lose weight which could benefit many people with diabetes. Prior to the study, it was known that mammals can switch from burning carbohydrates , like glucose, for energy towards burning fat instead. This allows mammals to get energy without breaking down muscle mass. It was thought that a decrease in insulin levels is all that was needed to help the switch to burning fat occur. However, the new research has identified that a reduction in leptin levels is also needed. Insulin and leptin are both hormones. Insulin works to decrease blood sugar levels by moving glucose out of the blood and into neighbouring cells where it can be used directly as fuel or stored as body fat. A higher level of insulin also prevents fat from being broken down for energy. Leptin is a hormone which is linked to appetite and plays a key role in energy regulation. In their study, the researchers from Yale investigated the rate of carbohydrate and fat metabolism as rats went from a fed to a fasted state. The researchers observed that as the rats fasted, leptin levels decreased and activated a pathway that led to fat burning rather than carbohydrate burning. During fasting, the rats' use of stored glucose went down and sugar levels decreased as a Continue reading >>
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Serum Leptin Levels In Children With Diabetes Type 1 And Its Relation With Diabetic Nephropathy And Retinopathy
Endocrine Abstracts (2017) 51 P061 | DOI: 10.1530/endoabs.51.P061 Serum leptin levels in children with diabetes type 1 and its relation with diabetic nephropathy and retinopathy Agnieszka Brandt1, Ewa Malinowska2, Katarzyna Zorena2 & Magorzata Myliwiec1 1Clinic of Pediatrics, Diabetology and Endocrinology, Gdansk, Poland; 2Medical University of Gdansk, Gdansk, Poland. Introduction: Type 1 diabetes mellitus is one of the most common chronic diseases in children. Precise knowledge of the pathogenesis of diabetes mellitus type 1 and its chronic complications is the enormous challenge in modern diabetology. In recent years, the role of leptin in the pathogenesis of microvascular diabetic complications has been highlighted. Aim: The aim of the study was to investigate serum leptin level and correlations between leptin levels and clinical and biochemical parameters in patients with diabetes mellitus. Materials and methods: The study included 110 patients with diabetes type 1, lasting 6.053.25 years, aged 14.373.13 years from Clinic of Pediatrics, Diabetology and Endocrinology, Medical University of Gdansk, Poland and 50 matched controls. Patients with type 1 diabetes mellitus were divided in two subgroups with and without late diabetic complications (albuminuria and ophtalmological changes). In all included to the study children: HbA1c, C-reactive protein, lipid profile, albuminuria and serum leptin level with enzyme immunoassay were performed. Results: Statistically significant differences in serum leptin level, among patients with long-term type 1 diabetes mellitus (7.638.41 ng/ml) and group of healthy children (9.586.61 ng/ml) were shown with the highest level in control group (P=0.04). In patients with symptoms of late diabetic complications were reported significantly h Continue reading >>
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Role Of Leptin Deficiency In Type 1 Diabetes
Home / Conditions / Type 1 Diabetes / Role of Leptin Deficiency in Type 1 Diabetes Role of Leptin Deficiency in Type 1 Diabetes A new study in rats shows that a lack of the hormone leptin triggers a cascade of neuroendocrine events that affects adipose tissue as well as the liver, resulting in hyperglycemia and ketoacidosis. Leptin is a hormone made by fat cells which regulates the amount of fat stored in the body. It does this by adjusting both the sensation of hunger and adjusting energy expenditures. Studies suggest that there is an inverse relationship between leptin levels and insulin secretion. It has also been suggested that the association between plasma leptin and diabetes may be a result of an underlying leptin resistance due to obesity. In leptin-deficient diabetic rats, systemic administration of leptin rapidly reversed ketoacidosis and normalized blood glucose levels by decreasing the delivery of glycerol and fatty acids to the liver. The effect of leptin occurred via decreased hypothalamic pituitary adrenal (HPA) axis activity. In other words, less ACTH was released from the pituitary gland, which results in less corticosterone (the equivalent of human cortisol) secretion from the adrenal gland and less corticosterone induced lipolysis of adipose tissue triglycerides. In addition, leptin reduces the availability of actyl-CoA, which activates pyruvate carboxylase, produced by hepatic fatty acid catabolism, which is responsible for the inhibition of conversion of pyruvate to glucose. These findings indicate that either leptin or downstream targets of leptin may have therapeutic potential for the treatment of diabetes. In contrast with the rat models used in the study, patients who have well controlled type 1 diabetes do not consistently have low plasma lept Continue reading >>
Leptin And Diabetes Are You Leptin Resistant?
Leptin and Diabetes Are You Leptin Resistant? We know insulin resistance contributes to Type 2 diabetes. But resistance to another hormone called leptin also contributes big time. Fortunately, we may be able to turn down both kinds of resistance. Leptin helps regulate body fat, in part by telling the brain what level of fat is in the body and how that level is changing. When fat stores are sufficient, it lets the brain know, Were full. We have enough food now. So stop eating. Some Indian scientists put it in more technical terms : The net action of leptin is to inhibit appetite, stimulate thermogenesis [heat production], [burn up fatty acids], decrease glucose, and reduce body weight and fat. Those are good things for most of us. We want that. But many people, especially fat people, are leptin resistant. Talking to the UK newspaper Daily Mail, anti-sugar crusader Robert Lustig, MD, said, This means thebrainno longer reads the signals saying the body is full, but instead assumes it is starving no matter how much food you continue to eat. So leptin resistance (LR) contributes to fatness in much the same way that insulin resistance (IR) contributes to Type 2 diabetes. In fact, the two frequently go together. Not always as we know, most fat people dont have diabetes, and many people with Type 2 are thin. But a huge number of people have both types of resistance, which is why fat people are more likely to get diabetes, and diabetes gets wrongly blamed on fat. In fact, Dr. Lustig believes insulin resistance triggers LR . Insulin blocks leptins fullness signals in the brain. His studies have found that lowering insulin levels stops cravings and helps people get control of their food consumption, presumably because leptin is working again. Scientists used to think increasing l Continue reading >>
Serum Leptin And Adiponectin Levels In Children With Type 1 Diabetes Mellitus Relation To Body Fat Mass And Disease Course - Sciencedirect
Volume 61, Issue 1 , March 2016, Pages 117-122 Serum leptin and adiponectin levels in children with type 1 diabetes mellitus Relation to body fat mass and disease course Author links open overlay panel Katarzyna AnnaMajewskaab Leptin and adiponectin are adipokines presenting a wide range of impacts, including glycemic balance regulations. Insulin is one of the main regulators of adipose tissue function. In type 1 diabetes mellitus (T1DM) endogenous insulin secretion is replaced by the exogenous supply, which is not regulated naturally. The aim of the study was to establish serum leptin and adiponectin levels, and their relations to body fat mass and disease course in children with T1DM. The study included 75 children with T1DM and the control group of 20 healthy coevals. All children had estimated serum leptin and adiponectin concentrations, lipid profile, and bioelectrical impedance analysis. Serum leptin concentrations in children with T1DM were not significantly different from the control group (p=0.067, mean valuesSD: 3.112.98 vs. 5.295.06g/l, respectively), and related positively to body fat mass in both groups. Adiponectin serum concentrations were significantly higher in children with T1DM than in the control group (p<0.001; mean values: 18.829.31 vs. 12.105.53g/ml, respectively), and were not related to the body fat content in the study group. Both, leptin and adiponectin, showed no relation to any of the analyzed parameters of the disease course. Differences observed between children with T1DM and their healthy coevals, when similar in terms of age, body weight, and body fat mass, seem not to depend directly on the disease duration, its metabolic control or insulin supply. Continue reading >>
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New Study Shows Leptin Treatment May Help Reduce Type 1 Diabetes
New study shows leptin treatment may help reduce type 1 diabetes Using leptin alone in place of standard insulin therapy shows promise in abating symptoms of type 1 diabetes, UT Southwestern Medical Center researchers report. UT Southwestern researchers, using mouse models, found that leptin administered instead of insulin showed better management of blood-sugar variability and lipogenesis, the conversion of simple sugars into fatty acids. Leptin is a hormone produced by fat cells and involved in the regulation of body weight. Dr. Roger Unger, professor of internal medicine at UT Southwestern, led the study whose findings are available online and in a future issue of the Proceedings of the National Academy of Sciences. Insulin treatment has been the gold standard for type 1 diabetes (insulin-dependent diabetes) in humans since its discovery in 1922. Dr. Unger's laboratory found that insulin's benefit resulted from its suppression of glucagon, a hormone produced by the pancreas that raises blood sugar levels in healthy individuals. "Insulin cells are destroyed in people with type 1 diabetes , however, and matching the high insulin levels needed to reach glucagon cells with insulin injections is possible only with amounts that are excessive for other tissues," said Dr. Unger, senior author of the latest study. "Peripherally injected insulin cannot accurately duplicate the normal process by which the body produces and distributes insulin." People on insulin therapy tend to experience large swings in blood-sugar levels, said Dr. Unger. Other studies have shown that frequent blood-sugar variation complicates the symptoms of type 1 diabetes, which affects about 1 million people in the U.S. Bariatric surgery successes pave way for new type 2 diabetes treatment Benefits of let Continue reading >>
European Commission : Cordis : Projects And Results : Metabolic Actions Of Brain Leptin Receptors Signaling In Type 1 Diabetes
Metabolic actions of brain leptin receptors signaling in type 1 diabetes Metabolic actions of brain leptin receptors signaling in type 1 diabetes From 2014-06-01 to 2019-05-31, ongoing project An established dogma is that insulin is absolutely required for survival. This notion has been supported by the fact that the sole life-saving intervention available to the millions affected by type 1 diabetes mellitus (T1DM; an illness caused by pancreatic -cell loss and hence insulin deficiency) is insulin therapy. This treatment however does not restore normal metabolic homeostasis. In fact, the life-expectancy and -quality of T1DM people is worse compared to normal subjects. In part, this is due to challenging morbidities of T1DM, as for example heart disease and hypoglycemia, both of which are thought to be caused by insulin therapy itself. Indeed, owing to insulins lipogenic actions, this treatment likely contributes to the ectopic lipid deposition (i.e.: in non-adipose tissues) and extremely high incidence of coronary artery disease seen in T1DM subjects. Also, due to insulins potent, fast-acting, glycemia-lowering action, this therapy significantly increases the risk of hypoglycemia; a disabling and life threatening event. Because insulin therapy does not restore metabolic homeostasis in T1DM subjects, better intervention is urgently needed. To these ends, we and others have shown that the hyperglycemic and lethal consequences of insulin deficiency can be rescued by administration of the adipocyte-secreted hormone leptin. Not only these results challenge an established view, they also raise a fundamental biological and medical question: what are the mechanisms by which leptin improves hyperglycemia and permits survival in the context of insulin deficiency? This proposal a Continue reading >>
