Glucose metabolism before and after treatment in patients with acromegaly

Endocrinol Diabetes Nutr. 2017 Aug-Sep;64(7):363-368. doi: 10.1016/j.endinu.2017.05.010. Epub 2017 Jul 1.
[Article in English, Spanish]

Abstract

Introduction: The aim of this study was to ascertain the prevalence of carbohydrate changes in patients diagnosed with acromegaly, and to evaluate what happens two years after treatment. It was also intended to assess which factors are associated to the occurrence of such changes.

Material and methods: Sixty-six patients diagnosed with acromegaly at our center were enrolled and divided into groups with normal glucose metabolism, prediabetes, and diabetes. After 2 years of treatment of acromegaly, prevalence carbohydrate changes was assessed again depending on the patient condition (cured, controlled with medical treatment, or uncontrolled).

Results: At the time of diagnosis of acromegaly, 27.3% of the patients had diabetes (n=18), 39.4% had prediabetes (n=26), and 33.3% had no changes (n=22). Significant differences were found in IGF-1 and z-score of IGF-1 (median of 18.1 in diabetics and 10.6 in non-diabetics, P=.005). Two years after treatment, there was a significant decrease in the prevalence of diabetes and prediabetes in cured patients (from 29.2% to 8.3% and from 45.8% to 16.7%, respectively, P=.003), but not in patients controlled with medical treatment or not controlled.

Conclusion: At our center, 66.6% of patients with acromegaly had changes in carbohydrate metabolism at diagnosis, with a prevalence of diabetes of 27.3%. Two years after treatment of acromegaly, prevalence of diabetes and prediabetes decreased in cured patients.

Keywords: Acromegalia; Acromegaly; Adenoma hipofisario; Diabetes; Pituitary adenoma; Prediabetes.

Publication types

  • Comparative Study

MeSH terms

  • Acromegaly / etiology
  • Acromegaly / metabolism*
  • Acromegaly / surgery
  • Adenoma / complications
  • Adenoma / surgery
  • Adult
  • Aged
  • Blood Glucose / analysis
  • Carbohydrate Metabolism
  • Female
  • Follow-Up Studies
  • Glucose / metabolism*
  • Glucose Metabolism Disorders / etiology
  • Glucose Metabolism Disorders / metabolism*
  • Glycated Hemoglobin / analysis
  • Growth Hormone-Secreting Pituitary Adenoma / metabolism
  • Growth Hormone-Secreting Pituitary Adenoma / surgery
  • Humans
  • Insulin-Like Growth Factor I / analysis
  • Male
  • Middle Aged
  • Tumor Burden

Substances

  • Blood Glucose
  • Glycated Hemoglobin A
  • IGF1 protein, human
  • Insulin-Like Growth Factor I
  • Glucose