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Glucose homeostasis in acromegaly: effects of long‐acting somatostatin analogues treatment
Author(s) -
Baldelli Roberto,
Battista Claudia,
Leonetti Frida,
Ghiggi MariaRosaria,
Ribaudo MariaCristina,
Paoloni Antonella,
D’Amico Eugenio,
Ferretti Elisabetta,
Baratta Roberto,
Liuzzi Antonio,
Trischitta Vincenzo,
Tamburrano Guido
Publication year - 2003
Publication title -
clinical endocrinology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.055
H-Index - 147
eISSN - 1365-2265
pISSN - 0300-0664
DOI - 10.1046/j.1365-2265.2003.01876.x
Subject(s) - acromegaly , endocrinology , medicine , somatostatin , glucose homeostasis , homeostasis , insulin , insulin resistance , hormone , growth hormone
Summary objective Acromegaly is a syndrome with a high risk of impaired glucose tolerance (IGT) and diabetes mellitus (DM). Somatostatin analogues, which are used for medical treatment of acromegaly, may exert different hormonal effects on glucose homeostasis. Twenty‐four active acromegalic patients were studied in order to determine the long‐term effects of octreotide‐LAR and SR‐lanreotide on insulin sensitivity and carbohydrate metabolism. design Prospective study. patients We studied 24 patients with active acromegaly, 11 males and 13 females, aged 50·7 ± 12·7 years, body mass index (BMI) 30·1 ± 4·8 (kg/m 2 ). measurements All patients underwent an oral glucose tolerance test (OGTT) and 12 also had an euglycaemic hyperinsulinaemic clamp. All patients were evaluated at baseline and after 6 months of somatostatin analogues therapy. results Acromegalic patients showed low M‐values in respect to the control group at baseline ( P < 0·05), followed by a significant improvement after 6 months of therapy ( P < 0·005 vs. baseline). Serum glucose levels at 120 min during OGTT worsened ( P < 0·05) during somatostatin analogs therapy in patients with normal glucose tolerance, but not in those with impaired glucose tolerance or diabetes mellitus. This was associated with a reduced ( P < 0·05) and 30 min delayed insulin secretion during OGTT. Also, HbA1c significantly deteriorated in all subjects after treatment (4·7 ± 0·6% and 5·1 ± 0·5%, basal and after six months, respectively, P < 0·005). conclusion In acromegalic patients, somatostatin analogues treatment reduces insulin resistance, and also impairs insulin secretion. This may suggest that the use of oral secretagogue hypoglycaemic agents and/or insulin therapy should be considered rather than insulin sensitizers, as the treatment of choice in acromegalic patients who develop frank hyperglycaemia during somatostatin analogues therapy.