Endocrine Abstracts

JOINT849

Introduction: Growth hormone is used to treat patients with a variety of growth disorders. A common side effect of growth hormone therapy is hyperglycemia. Monitoring for hyperglycemia in patients on growth hormone therapy is done via HbA1C. However, the exact timing of the changes in glucose levels experienced by high-risk patients on growth hormone therapy has not been widely studied. Insight into the glucose levels in these patients can help providers to manage hyperglycemia earlier in the course of treatment. The advent of Continuous Glucose Monitoring Systems (CGMS) allows patients to be able to obtain real time glucose data at multiple time points.

Objectives and hypotheses: To use CGMS to monitor glucose levels in high-risk patients on growth hormone therapy to identify early changes in glucose levels. Also, to assess if there are differences in glucose patterns in high-risk patients on daily vs weekly growth hormone therapy.

Methods: FreeStyle Libre 3 CGM will be used to monitor glucose levels in high-risk patients on growth hormone therapy. High risk patients would be defined as patients with BMI>86%; those with family history of Type 2 DM and those with baseline elevated HbA1C (above 5.6%). At risk patients would have a CGMS placed to monitor glucose levels. Those with noted abnormal glucose levels would then have another CGMS placed 2 months after interventions to look for improvement in glucose levels. Hba1C would continue to be monitored as per standard of care. Data will be stratified by risk factors and whether patient used daily vs weekly growth hormone.

Results: Preliminary results on a patient with family history of Type 2 DM and an increase in Hba1C from 5.7% to 6% was placed on CGMS. CGMS data showed glucose levels as high as 178 mg/dL with multiple times where the blood glucose levels were above 140 mg/dL. Data is currently being collected from additional patients on growth hormone therapy.

Conclusions: The data obtained from this study can demonstrate that the use of CGMS to monitor at risk patients on growth hormone therapy can help providers to identify changes in glucose levels earlier, allowing them to make changes in management before there are significant changes in Hba1C. It will also help to examine whether there are differences in glucose patterns in daily vs weekly growth hormone formulations. The data obtained in this study could lead to changes in the management of patients on growth hormone therapy.