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A new pharmacologic agent, possible to be used in reducing insulin resistance

T. MOGO, ANDRA IACOBINI, CLAUDIA-VALERIA CHELAN


Prof. Dr. N.C. Paulescu National Institute of Diabetes, Nutrition and Metabolic Diseases

Insulin resistance is the cornerstone of multiple diseases such as metabolic syndrome, diabetes
mellitus, arterial hypertension, dyslipidemia, acute coronary syndrome, etc.
There are some medications and changes in lifestyle that can reduce insulin resistance. Not all
are suitable for all patients.
We discovered another pharmacologic agent that can be successfully added to the old methods
already in use.
Key words: insulin resistance, Gerovital H3, metabolic syndrome.

Insulin resistance (IR) is one of the cornerstones of several syndromes with large impact on
arterial diseases: metabolic syndrome, diabetes
mellitus, hypertension, acute coronary syndrome,
etc. [1,4].
There are a lot of known methods that reduce
IR, but their efficiency is not always long-lasting
and not so powerful for every product [3]. That is
why in the treatment of IR we combine different
methods adapted to every patients needs, in order
to obtain the maximum benefit for the individual
therapy [3,4]. The methods of reducing IR include
weight loss, physical activity, medication (metformin,
pioglitazone), correction of hyperglycemia, hypernatremia, hyperlipidemia, etc. [2,5].
As we already mentioned, depending on the
present factors that increase IR, we adapt the therapy
to every patients needs. Unfortunately, there are a
lot of other not yet identified factors that make IR
present and capable of inducing dysfunction or
atherosclerosis of the arterial vessels [11].
As a result of an extensive experience in the
field of IR, we observed that this phenomenon can
also be reduced by other methods. One of them was
far more efficient compared with the others. It is a
product with an international name (Gerovital H3)
usually used in geriatric medicine. We observed
that this pharmacologic agent improves insulin sensitivity, not only in the insulin-treated patients. We
administered 10 mL of this substance by i.m. injection
every day, for the period taken in observation.
ROM. J. INTERN. MED., 2014, 52, 4, 233238

MATERIALS AND METHODS

Our study was carried out on 416 patients


with IR. We analyzed them from January 2013
until September 2014. Most of the subjects were
females (215), the rest being males (201). From the
female group, 54 had diabetes mellitus and from
the male group, 32 suffered from diabetes. These
patients have been separately analyzed in a particular
way, as we will later show. The other IR patients
were not separately analyzed because a part of their
conditions were not connected with our field of
medicine.
Among those investigated, the duration of IR
was unknown, but we did know the duration of the
syndromes that can associate with IR: for metabolic
syndrome (11 2 years), for diabetes mellitus (9
3 years), hypertension (14 4 years), acute
coronary syndromes (7 2 years).
The patients average age was 54 11 years
(58 12 years for women; 50 11.2 years for
men). The mean BMI was 28.9 1.5 kg/m2 in the
male group and 30.2 1.8 kg/m2 in the female
group, with a reduced statistical difference (p <
0.05).
We determined each subjects IR using the
HOMA method. For the insulin-treated group we
measured the daily insulin requirement at the
beginning of treatment and after treatment with
Gerovital H3 (2 weeks). For the rest of the patients,
we determined HOMA-IR at the beginning and

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after 2 weeks of treatment. The glycemic values


were evaluated by blood sugar samples using the
Accu-Chek Active .
We stress that none of the patients received
any education regarding lifestyle changes and did
not have any other factors (such as medication) that
could influence their IR.
For a selected group of 10 subjects we
extended the treatment for another week.
RESULTS

The parameters of IR, for all patients taken in


observation, associated or not with the syndromes
usually depending on IR, indicated at the beginning
of the study a value for HOMA-IR of 2.8 0.5 for
the male group and of 3.1 0.8 for the female
group (p < 0.001). As we already mentioned,
following a 2 weeks treatment with Gerovital H3 ,
the value of HOMA-IR for the male group
unexpectedly decreased from 2.8 0.5 to 2.5 0.4
and in the female group from 3.1 0.8 to 2.6 0.9
(p < 0.001).
For the rest of the patients that did not receive
this treatment, there was no decrease in IR, which
could have a negative impact on healthcare.
In Figure 1 and Figure 2 we illustrate the
difference between the two levels of IR, at the
beginning and after 2 weeks of treatment, in the
female vs. the male group.

As we already mentioned, for the 10 subjects


(5 males and 5 females), the period of Gerovital H3
injection was prolonged for another week. As a
male group (Figure 4) from 2.8 0.5 to 2.3 0.4.
These results show us that treatment over longer
periods of time further decreases IR (Figure 5 and
Figure 6).
The IR decrease is maintained about three
weeks after the end of 2 weeks of treatment and
lasts for more than 25 days after 3 weeks of
treatment.
As we mentioned above, for the subjects with
IR that associated diabetes mellitus we measured
the total daily requirements at the beginning and at
the end of the two weeks of treatment and also the
mean blood sugar at the start and at the end of the
study. At the beginning of the study, the mean
glycemia in the male group was 168.5 12 mg/dL,
respectively174.4 11.6 mg/dL for the female
group (p < 0.001). The total daily insulin requirement for the male group was 34.5 8 units and for
the female group 39.2 7.8 units (p < 0.05). The
patients had similar diets, physical activity and BMI.
After 2 weeks, we measured the total daily
insulin requirements. For the male group, the total
daily dose of insulin decreased from 34.5 8.4 to
24.3 2.8 units and for the female group from 39.2
7.8 to 27.8 6.9 units (Figure 7) (p < 0.01)
The mean glycemia decreased in the female
group from 174.4 11.6 mg/dL to 122.5
11.4 mg/dL and in the male group from 168.5
12 mg/dL to 130.5 10.2 mg.dL (Figure 8).

Figure 1. Decrease of the HOMA-IR in the female group (215 pts.).

A new pharmacologic agent

Figure 2. Decrease of the HOMA-IR in the male group (201 pts.).

Figure 3. Further decrease of the HOMA-IR in 5 women


that continued Gerovital H3 treatment for another week.

Figure 4. Further decrease of the HOMA-IR in 5 men


that continued Gerovital H3 treatment for another week.

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T. Mogo et al.

Figure 5. Decrease in IR in the female group after 2w and 3w of treatment with Gerovital H3.

Figure 6. Decrease in IR in the male group after 2w and 3w of treatment with Gerovital H3.

Figure 7. Decrease of the total daily insulin requirements after treatment with Gerovital H3.

A new pharmacologic agent

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Figure 8. Decrease of the glycaemic levels after treatment with Gerovital H3.

DISCUSSION

From the results presented in the context of


treatment with Gerovital H3 we seem to have
found a new method to reduce the IR. From the
clinical practice point of view, having used plenty
of anti-IR agents and not having reached the results
we were expecting, we are looking for other
opportunities in order to achieve our target [6,7]. In
this way, the Gerovital H3 seems to be an optimal
solution, even if the effect lasts only for a short
period of time (weeks). We observed that patients
with IR and unbalanced diabetes could have a
benefit from the Gerovital H3 therapy, by
reducing IR and by balancing the glycaemic levels
and insulin requirements.
Until now we could not find a realistic
mechanism to explain the reduction in IR after this
kind of treatment. There are different opinions on
this subject. We shall mention only some of them: a
reduction in apoptosis, activation of lipoproteinlipase, a better vascularization of tissues (it is
known that this reduces IR) and a better stimulation
of the beta-cell activity [810]. It is possible that
the component in Gerovital H3 improves the
function of the central nervous system and by these
means decreases the response in catecholamines
and glucocorticoids in the peripheral area. It is well
known that these hormones act in opposite manner
to insulin, resulting in increased IR [12,13].
The fact that IR increases with age could be
another medical indication for the use of this
product [14].

We should take into account that Gerovital


H3 should be administered periodically [15], so that
its effect on reducing IR can be maintained over a
long period of time. On the other hand, we must
stress that the pathological conditions associated
with age could be improved if the patients take
several periodical cures of Gerovital [16,17]. From
our clinical experience, we are convinced that the
more the Gerovital H3 is given in a cure, the
bigger the decrease in IR is observed.
An interesting fact we noticed was that
women respond better to the treatment when
compared to men, even if their BMI is a bit greater
than that of males (30.2 1.8 vs. 28.9 1.5).

CONCLUSION

1. We found a new agent that improves


insulin resistance.
2. It is a good therapeutic solution for those
especially situated in the geriatric area.
3. The degree of limiting of IR seems to be
more evident in women that in men.
4. The beneficial aspect of reducing IR can be
used in plenty of syndromes associated with IR,
such as metabolic syndrome, diabetes mellitus,
dyslipidemia, arterial hypertension and acute coronary
syndromes.
5. The action of Gerovital H3 continues
weeks after the end of treatment.

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Insulinorezistena este piatra de temelie a mai multor afeciuni, cum ar fi


sindromul metabolic, diabetul zaharat, hipertensiunea arterial, dislipidemia,
sindromul coronarian acut etc.
Exist unele medicaii, dar i unele schimbri ale stilului de via care pot
altera rezistena la insulin. Nu toate aceste modaliti sunt potrivite pentru toi
pacienii. Noi am descoperit un alt medicament care poate fi adugat cu success
celorlalte metode mai vechi de reducere a insulinorezistenei.
Corresponding author: T. Mogos
Prof. Dr. N.C. Paulescu National Institute of Diabetes,
Nutrition and Metabolic Diseases
E-mail: tibimogos@yahoo.com
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Received September 28, 2014