Endocrine Abstracts

Introduction: Endocrine society guidelines advocate early colonoscopy and monitoring for acromegaly-associated complications and recurrence. We aimed to establish whether people with acromegaly under our care received appropriate monitoring.

Methods: Patients under follow-up with acromegaly diagnosed 1989-2021 were included. Electronic health records were accessed for clinic letters, colonoscopy reports, blood and imaging results from the diagnosis to recent follow-up.

Results: Twenty-two patients are included, with a mean age 47.5±17.1 years at diagnosis, mean disease duration 15.3±10.5 years, 2 (9.1%) had pre-existing type 2 diabetes (T2D), and 11 (50.0%) are male. Surgery was undertaken in 18 (81.8%), of whom 2 developed recurrent disease, and 4 managed medically from diagnosis. Five (22.7%) patients had colonoscopy within 12 months of diagnosis and a total of 11 (50.0%) patients had a colonoscopy since their diagnosis of acromegaly. Of these, three demonstrated colonic polyps of whom one had repeat colonoscopy within 5 years, one declined further endoscopy, and the other had no repeat endoscopy in 6 years. Over follow-up, 4 (18.2%) developed new T2D. In the last year, 18/22 (81.8%) had a serum IGF-1, 12/22 (54.5%) had HbA1c, and in the last 3 years 16/22 (72.7%) had repeat pituitary imaging. Of the 6 patients on somatostatin analogues or growth hormone antagonists, 4 (66.7%) had liver function tests in the last 6 months.

Discussion: Patients with acromegaly under our care infrequently had colonoscopy surveillance, and almost half did not have diabetes screening in the last year. We will develop local practice standards for annual review, and re-audit.