, Volume 51, Issue 2, pp 298–307 | Cite as

Preoperative octreotide therapy and surgery in acromegaly: associations between glucose homeostasis and treatment response

  • R. Helseth
  • S. M. Carlsen
  • J. Bollerslev
  • J. Svartberg
  • M. Øksnes
  • S. Skeie
  • S. L. FougnerEmail author
Original Article


In acromegaly, high GH/IGF-1 levels associate with abnormal glucose metabolism. Somatostatin analogs (SSAs) reduce GH and IGF-1 but inhibit insulin secretion. We studied glucose homeostasis in de novo patients with acromegaly and changes in glucose metabolism after treatment with SSA and surgery. In this post hoc analysis from a randomized controlled trial, 55 de novo patients with acromegaly, not using antidiabetic medication, were included. Before surgery, 26 patients received SSAs for 6 months. HbA1c, fasting glucose, and oral glucose tolerance test were performed at baseline, after SSA pretreatment and at 3 months postoperative. Area under curve of glucose (AUC-G) was calculated. Glucose homeostasis was compared to baseline levels of GH and IGF-1, change after SSA pretreatment, and remission both after SSA pretreatment and 3 months postoperative. In de novo patients, IGF-1/GH levels did not associate with baseline glucose parameters. After SSA pretreatment, changes in GH/IGF-1 correlated positively to change in HbA1c levels (both p < 0.03). HbA1c, fasting glucose, and AUC-G increased significantly during SSA pretreatment in patients not achieving hormonal control (all p < 0.05) but did not change significantly in patients with normalized hormone levels. At 3 months postoperative, HbA1c, fasting glucose, and AUC-G were significantly reduced in both cured and not cured patients (all p < 0.05). To conclude, in de novo patients with acromegaly, disease activity did not correlate with glucose homeostasis. Surgical treatment of acromegaly improved glucose metabolism in both cured and not cured patients, while SSA pretreatment led to deterioration in glucose homeostasis in patients not achieving biochemical control.


Somatostatin analogues Acromegaly Glucose homeostasis Medical treatment of acromegaly Pituitary surgery 



The study was performed by the POTA study group which is a subgroup of the “Norwegian Neuroendocrine Interest group” (NNI). The annual meetings of NNI are supported by Novartis Norway. The study was also directly supported by Novartis Norway who paid the salary for a part-time study nurse (20 % position), supported the drug used (Sandostatin® and Sandostatin LAR®) free of charge, and carried the expenses when the study nurse checked the raw data at each study site.

Compliance with Ethical Standards

Conflict of interest

SLF has received speaker honorariums from Ipsen and Novartis. The other authors have nothing to declare.

Supplementary material

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Supplementary material 1 (PPTX 934 kb)


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Copyright information

© Springer Science+Business Media New York 2015

Authors and Affiliations

  • R. Helseth
    • 1
  • S. M. Carlsen
    • 2
    • 3
  • J. Bollerslev
    • 4
    • 5
  • J. Svartberg
    • 6
    • 7
  • M. Øksnes
    • 8
  • S. Skeie
    • 9
  • S. L. Fougner
    • 2
    Email author
  1. 1.Department of Internal MedicineDrammen Hospital, Vestre VikenDrammenNorway
  2. 2.Department of Endocrinology, Medical ClinicSt. Olavs University HospitalTrondheimNorway
  3. 3.Unit for Applied Clinical ResearchNorwegian University of Science and Technology (NTNU)TrondheimNorway
  4. 4.Section of Specialized Endocrinology, Department of EndocrinologyOslo University Hospital, RikshospitaletOsloNorway
  5. 5.Faculty of MedicineUniversity of OsloOsloNorway
  6. 6.Division of Internal MedicineUniversity Hospital of North NorwayTromsøNorway
  7. 7.Tromsø Endocrine Research Group, Institute of Clinical MedicineUiT The Arctic University of NorwayTromsøNorway
  8. 8.Department of Medicine and Centre for Clinical ResearchHaukeland University HospitalBergenNorway
  9. 9.Division of MedicineStavanger University HospitalStavangerNorway

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