Current and Emerging Aspects of Diabetes Mellitus in Acromegaly

Diabetes mellitus is a frequent complication of acromegaly, a disease characterized by chronic hypersecretion of growth hormone (GH) by a pituitary adenoma. Diabetes occurs commonly but not only as a consequence of an insulin-resistant state induced by GH excess. The development of diabetes in patients with acromegaly is clinically relevant, since such a complication is thought to increase the already elevated cardiovascular morbidity and mortality risk of the disease. Emerging data suggest that a specific cardiomyopathy can be identified in acromegaly patients with diabetes. Moreover, the presence of diabetes may also influence therapeutic decision making in acromegaly, since traditional and newly developed drugs used in this clinical setting may impact glucose metabolism regardless of control of GH hypersecretion.

TrendsDiabetes mellitus is a frequent complication of acromegaly due to the effects of growth hormone hypersecretion on insulin sensitivity and secretion.The occurrence of diabetes mellitus in acromegaly is associated with high cardiovascular morbidity and mortality.Diagnosis of acromegaly in patients with coexistent diabetes mellitus is challenging since the OGTT may be contraindicated and serum insulin-like growth factor-1 values are influenced by altered glucose levels and insulin sensitivity.Drugs used to control growth hormone hypersecretion may affect glucose metabolism.