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This therapeutic approach involves the combination of recombinant human growth hormone (somatropin) and the insulin-sensitizing agent metformin. It is being investigated in a clinical trial (NCT02931591) sponsored by Cambridge University Hospitals NHS Foundation Trust, specifically for children born small for gestational age (SGA) who exhibit short stature. The study, led by Professor David Dunger and Dr. Ajay Thankamony, explores the hypothesis that insulin sensitivity is a key determinant of the growth response to growth hormone therapy. Somatropin acts as an agonist at the growth hormone receptor to stimulate the production of insulin-like growth factor-1 (IGF-1), while metformin is added to improve insulin sensitivity, potentially enhancing the IGF-1 response and improving overall growth outcomes in children with genetic predispositions to lower insulin sensitivity. The research is supported by an investigator-initiated grant from Merck KGaA.
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