Is type-2 adult diabetes a variety of idiohypophyseal diabetes? A proposition that opens perspectives

The advances in the study of the role of growth hormone (GH) in the field of diabetes, confining clinically its glucoregulatory and diabetogenic effects, plus relevant findings in basic research, open new perspectives. The influence of GH on Type-2 diabetes is based on the classic experiments of Houssay's school, the diabetogenic action of GH and its transferrin mediator. Since GH is under hypothalamic command, the permanent GH hypersecretion is the pathophysiological evidence for hypothalamic dysfunction. Thus, type-2 diabetes is postulated as a reversible type of clinical idiohypohyseal diabetes. Different degrees of hypophyseal diabetes can be observed, with the interplay between insulin-growth factor-l and transferrin in some cases of acromegaly. In cases of selective predominance of GH and the consequent chronic elevation of transferrin levels, idiohypophyseal diabetes would develop. Therefore, this type of diabetes should be treated with hypothalamic GH inhibitors. In this line of thinking, the use of somatostatin analogs looks promising.