A study of central serotoninergic activity in healthy subjects and patients with Type 2 diabetes treated by traditional one-to-one care or Group Care

作者：Trento M^*; Kucich C; Tibaldi P; Gennari S; Tedesco S; Balbo M; Arvat E; Cavallo F; Ghigo E; Porta M

来源：Journal of Endocrinological Investigation, 2010, 33(9): 624-628.

DOI：10.3275/6815

• Type 2 diabetes
• Group Care
• serotonin
• hypothalamus pituitary adrenal axis

Aim Central serotoninergic activity may modulate glucose metabolism via neuroendocrine effectors Group Care is a clinico pedagogic intervention that improves metabolic control and quality of life in Type 2 diabetes through lifestyle modification and possibly central mechanisms The hypothesis that central serotoninergic activity is modified in patients followed by Group Care was tested by measuring their hypothalamic pituitary adrenal response to citalopram, a selective serotonin reuptake inhibitor Methods and subjects Ten healthy controls and 17 non-obese non insulin treated patients with Type 2 diabetes received in random order, iv infusions of either 20 mg citalopram or saline Nine patients had been long term on Group Care and 8 had always been on traditional one-to one care Circulating glucose insulin, ACTH, cortisol DHEA GH and PRL were measured every 15 min for 240 min Differences between areas under the curves after citalopram and saline (Delta-AUC) were calculated Results Citalopram stimulated ACTH and cortisol secretion in healthy subjects (p=0 026 and p=0 011 respectively) and patients on Group Care (p=0 056 and p=0 038) but not in patients on traditional care In healthy subjects basal glucose correlated with growth hormone A AUC (r=0 820, p=0 004) and inversely with insulin A AUC (r=-0 822 p=0 003) The former correlation was preserved in the patients (r=0 637 p=0 026) Conclusions Diabetes may blunt the response of the hypothalamic pituitary adrenal axis to citalopram, but this

• 出版日期2010-10