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Occurrence of impaired fasting glucose in GH‐deficient adults receiving GH replacement compared with untreated subjects
Author(s) -
Woodmansee Whitney W.,
Hartman Mark L.,
Lamberts Steven W.J.,
Zagar Anthony J.,
Clemmons David R.
Publication year - 2010
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 - 10.1111/j.1365-2265.2009.03612.x
Subject(s) - medicine , endocrinology , fasting glucose , insulin , insulin resistance
Summary Objective The effects of GH replacement on glucose metabolism in GH‐deficient (GHD) adults in clinical practice are not well defined. Therefore, we assessed GH treatment effects on fasting plasma glucose (FPG) and haemoglobin A1c (A1c) concentrations in GHD adults in a clinical setting. Design Post‐hoc analysis of the observational Hypopituitary Control and Complications Study conducted at 157 US centres (1997–2002). Patients GH‐deficient adults who were GH‐naïve at study entry and had at least two FPG measurements. Measurements Effect of GH treatment on the frequency and time course of abnormal FPG (≥5·6 mmol/l) development, FPG normalization, progression of increased FPG and abnormal follow‐up A1c (>6%) values in GHD patients treated with GH ( n = 403) or untreated ( n = 169) at their physician’s discretion. Results In subjects without pre‐existing diabetes mellitus, development of an abnormal FPG tended to occur in a greater percentage of GH‐treated than untreated subjects (35·3% versus 24·5, P = 0·06). Additionally, GH treatment was associated with a mild, transient increase in FPG and shorter time to development of an abnormal FPG in these subjects ( P < 0·01). Most (∼80%) abnormal FPG values were below 7 mmol/l and normalized in 69% of GH‐treated subjects without diabetes. Treatment with GH had no effect on the rate of FPG normalization, progression of increased FPG or abnormal follow‐up A1c values. Conclusions Initiation of GH replacement in GHD adults was associated with a mild increase in FPG that often normalized spontaneously. Nevertheless, clinicians should monitor FPG in patients receiving GH treatment.