Marked alteration of glycemic profile surrounding lanreotide administration in acromegaly: A case report

J Diabetes Investig. 2018 Jan;9(1):223-225. doi: 10.1111/jdi.12675. Epub 2017 Jun 26.

Abstract

Whether somatostatin analogs for acromegaly improve or worsen a patient's glycemic profile is controversial. A risk of hypoglycemia should be presumed, especially when patients receive insulin therapy, as the package inserts caution. However, a detailed clinical course of such a case has never been reported in research articles. An 80-year-old Japanese female diabetes patient treated with insulin therapy was diagnosed with acromegaly, and the somatostatin analog, lanreotide, was given. On day 4 of lanreotide treatment, repeated hypoglycemia as a result of exogenous insulin arose and the patient required inpatient care. After lanreotide treatment, the total daily insulin dose could be reduced, but her fasting C-peptide level decreased from 1.6 to 0.4 ng/mL, implying improved insulin resistance and impaired endogenous insulin secretion. In the present case, marked alteration surrounding lanreotide administration was observed; careful co-administration with insulin therapy is required, as the package insert cautions.

Keywords: Acromegaly; Diabetes mellitus; Lanreotide.

Publication types

  • Case Reports

MeSH terms

  • Acromegaly / complications
  • Acromegaly / drug therapy*
  • Aged, 80 and over
  • Blood Glucose
  • Diabetes Complications*
  • Diabetes Mellitus / drug therapy
  • Female
  • Humans
  • Hypoglycemia / chemically induced*
  • Hypoglycemic Agents / therapeutic use
  • Insulin / therapeutic use
  • Peptides, Cyclic / adverse effects*
  • Somatostatin / adverse effects
  • Somatostatin / analogs & derivatives*

Substances

  • Blood Glucose
  • Hypoglycemic Agents
  • Insulin
  • Peptides, Cyclic
  • lanreotide
  • Somatostatin