Glucose homeostasis in acromegaly: Effects of long-acting somatostatin analogues treatment

Roberto Baldelli, Claudia Battista, Frida Leonetti, Maria Rosaria Ghiggi, Maria Cristina Ribaudo, Antonella Paoloni, Eugenio D'Amico, Elisabetta Ferretti, Roberto Baratta, Antonio Liuzzi, Vincenzo Trischitta, Guido Tamburrano

Research output: Contribution to journalArticlepeer-review

Abstract

OBJECTIVE: Acromegaly is a syndrome with a high risk of impaired glucose tolerance (IGT) and diabetes mellitus (DM). Somatostatin analogues, which are used for medical treatment of acromegaly, may exert different hormonal effects on glucose homeostasis. Twenty-four active acromegalic patients were studied in order to determine the long-term effects of octreotide-LAR and SR-lanreotide on insulin sensitivity and carbohydrate metabolism. DESIGN: Prospective study. PATIENTS: We studied 24 patients with active acromegaly, 11 males and 13 females, aged 50.7 ± 12.7 years, body mass index (BMI) 30.1 ± 4.8 (kg/m2). MEASUREMENTS: All patients underwent an oral glucose tolerance test (OGTT) and 12 also had an euglycaemic hyperinsulinaemic clamp. All patients were evaluated at baseline and after 6 months of somatostatin analogues therapy. RESULTS: Acromegalic patients showed low M-values in respect to the control group at baseline (P <0.05), followed by a significant improvement after 6 months of therapy (P <0.005 vs. baseline). Serum glucose levels at 120 min during OGTT worsened (P <0.05) during somatostatin analogs therapy in patients with normal glucose tolerance, but not in those with impaired glucose tolerance or diabetes mellitus. This was associated with a reduced (P <0.05) and 30 min delayed insulin secretion during OGTT. Also, HbA1c significantly deteriorated in all subjects after treatment (4.7 ± 0.6% and 5.1 ± 0.5%, basal and after six months, respectively, P <0.005). CONCLUSION: In acromegalic patients, somatostatin analogues treatment reduces insulin resistance, and also impairs insulin secretion. This may suggest that the use of oral secretagogue hypoglycaemic agents and/or insulin therapy should be considered rather than insulin sensitizers, as the treatment of choice in acromegalic patients who develop frank hyperglycaemia during somatostatin analogues therapy.

Original languageEnglish
Pages (from-to)492-499
Number of pages8
JournalClinical Endocrinology
Volume59
Issue number4
DOIs
Publication statusPublished - Oct 1 2003

ASJC Scopus subject areas

  • Endocrinology

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