Searchable abstracts of presentations at key conferences in endocrinology
Endocrine Abstracts (2009) 20 P546

ECE2009 Poster Presentations Neuroendocrinology, Pituitary and Behaviour (74 abstracts)

The prevalence of diabetes mellitus in 9776 adult patients with childhood- and adult-onset growth hormone (GH) deficiency before GH replacement: a KIMS analysis

Roger Abs 1 , Anton Luger 2 , Patrick Wilton 3 , Maria Thunander 4, , Johan Verhelst 6 , Miklos Goth 7 , Maria Koltowska-Haggstrom 8 & Anders Mattsson 8


1Department of Endocrinology, University of Antwerp, Antwerp, Belgium; 2Universitätsklinik fur Innere Medizin III, Klinik Abt. fur Endokrinologie und Stoffwechsel, Vienna, Austria; 3Pfizer Endocrine Care, Pfizer Ltd, New York, New York, USA; 4Department of Internal Medicine, Central Hospital, Vaxjo, Sweden; 5Department of Diabetology and Endocrinology, Lund University, Lund, Sweden; 6Department of Endocrinology, General Hospital Middelheim, Antwerp, Belgium; 7Division of Endocrinology, Department of Medicine, National Medical Centre, Budapest, Hungary; 8KIMS Medical Outcomes, Pfizer Endocrine Care, Sollentuna, Sweden.


Background: Untreated GH-deficiency (GHD) in adults has been suggested to be associated with an increased prevalence of type 2 diabetes mellitus (DM). Proposed causative factors are the tendency to overweight and the insulin resistance due to central adiposity.

Patients and methods: The KIMS (Pfizer International Metabolic Database) was used to evaluate the prevalence of DM in both childhood-onset (CO; n=1977; 56% males) and in adult-onset (AO; n=7799; 48% males) GHD patients before start of GH replacement as adults. In adulthood, mean age at initiation of GH treatment in CO was 28 (S.D.: 11) and in AO 49 years (S.D.: 13). Observed/expected prevalence ratios (PRs) were based on 5-year age-groups. Expected prevalence was calculated with published age-specific estimates on global prevalence of diabetes (Diabetes Care, 27(5):1047–1053, 2004).

Results: In CO-GHD, 42 patients (2.12%; 50% males) presented with DM vs 1.34% expected (PR=1.6 95% CI 1.15–2.15). PR was elevated in the younger age groups (10.5, 4.2 and 1.7 in the age-groups of 20–24, 25–29, and 30–39 years, respectively). For older age groups PRs were similar to expected. Impaired fasting glucose (IFG) was found in 60 patients (3.0%; 63% males). Mean BMI was 33.5 in DM, 26.9 in IFG, and 26.5 kg/m2 in non-diabetics.

In AO-GHD, 631 patients (8.19%; 43% males) presented with DM vs expected 6.57% (PR=1.25; 95% CI 1.15–1.35). PRs were elevated in age groups below 50 years (18.6, 7.0, 5.5, 2.7, 1.7 and 1.3 in age-groups of 20–24, 25–29 30–34, 35–39, 40–44, and 45–49 years, respectively) and similar to expected in ages above 50 years. IFG were found in 355 patients (4.6%; 46% males). Mean BMI was 33.2, 31.0 and 29.2 kg/m2 in DM, IFG, and non-diabetic patients, respectively.

Conclusions: Untreated GHD is associated with an increased prevalence of DM in both CO- and AO-GHD, predominantly in younger patients.

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