Handshake diagnosed brain tumour

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Permalink Reply by Ross on February 20, 2008 at 12:31am

v impressive, just goes to show that clinical observation really does start in the waiting room.
Ive only seen 1 proper case of acromegaly in my brief carrear but I have noticed a number of insulin dependant diabetics who seem "acromegaloid" a couple of whom have quite marked symptoms. The mechanism is thought to be due to insulin growth factor IGF1 causing proliferation of osteoblasts at metaphyseal ends of bone (i think).

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Permalink Reply by Clement Rhein on March 11, 2008 at 8:58pm

Do you know why there is this link between insulin and Growth? What is the point?

And, don't insulin dependent diabetics have less insulin than non-diabetics, or even syndrome X people?

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Permalink Reply by Ross on March 12, 2008 at 11:40am

excessively high blood insulin levels, as distinct from hyperinsulinism, excessive secretion of insulin via pancraetic islet cells. Hyperinsulinaemia may result from a variety of conditions such as obesity, pregnancy or poorly controlled blood sugar in an insulin dependant diabetic (using too much insulin)

It goes the other way too in that the ability of growth hormone to antagonize insulin's action has long been known and explains why acromegaly is complicated by severe insulin resistance and sometimes by overt diabetes. In patients with active acromegaly, basal insulin concentration shows two- to threefold elevations. That said im unsure about exactly how it works... any takers?

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