Context: Therapy with somatostatin analogues (SSAs) may have deleterious effects on glucose metabolism in patients with acromegaly, often leading to development of diabetes mellitus (DM).
Aim of the study: To evaluate whether DM, which developed during therapy with SSAs, may revert after drug withdrawal and cure of acromegaly with pituitary adenomectomy.
Design: Retrospective cohort study, in a tertiary referral center.
Patients: Eighteen acromegalic patients without DM at the diagnosis of acromegaly treated with SSAs as a primary therapy, and then cured by pituitary adenomectomy.
Methods: Endocrine status and glucose homeostasis were evaluated at diagnosis of acromegaly and at least every six months during SSAs therapy. At each control patients were classified in one of the following classes: normal glucose tolerance, prediabes, overt diabetes.
Results: Median follow-up after starting SSAs therapy was 60 months (IQR 53.296.2). During SSAs therapy, all patients had controlled acromegaly defined by normal serum IGF-1 concentrations for the age. Among the 13 euglycaemic patients at diagnosis three developed prediabetes and three diabetes, whereas, among the five prediabetic patients at diagnosis two worsened to overt diabetes; three remained in the prediabetic range (P=0.04). After cure of acromegaly with pituitary adenomectomy and subsequent SSAs withdrawal, prediabetes reverted in five out of six patients, and diabetes in all five patients (in three reverted to euglycaemia, while in two reverted to prediabetes) (P=0.01).
Conclusions: In acromegalic patients with controlled disease changes of glycaemic status induced by SSAs are not permanent.
20 - 23 May 2017
European Society of Endocrinology