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Glucose status in patients with acromegaly receiving primary treatment with the somatostatin analog lanreotide

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Abstract

To describe glucose status changes in patients with acromegaly receiving somatostatin analog lanreotide as primary treatment. This retrospective, single-center study conducted during 1996–2008, included acromegalic patients receiving primary lanreotide treatment. Baseline and last follow-up visit assessments included glucose status (according to American Diabetes Association criteria), growth hormone (GH), and insulin-like growth factor-1 (IGF-1) levels. Glucose control was considered improved when fasting plasma glucose or antidiabetic treatments were reduced, and deteriorated if fasting glucose was the same/higher but with increased antidiabetic treatments. 42 patients (median age 50 years; range 29–75 years) were included. At baseline, 26 (62%) were normoglycemic, eight (19%) had impaired glucose tolerance/fasting glycemia, and eight (19%) had diabetes mellitus; family history of diabetes mellitus was significantly associated with abnormal glucose status. At final visit, the mean (SE) lanreotide dose was 108 (21) mg/month. Median treatment duration was 23 months, range 3–138 months, and 74% of patients received the 120-mg dose. Median GH levels decreased significantly (baseline, 12 [5–20] μg/l; final visit, 2.1 [1.0–4.7] μg/l; P < 0.0001); IGF-1 levels were age- and sex-normalized in 33% of patients. Glucose control deteriorated in seven patients (17%) and improved from abnormal levels in 10 (24%). Deterioration was associated with smaller GH decreases (median change, −3.4 μg/l vs. −10.7 μg/l, P = 0.014) and improvement with trend to lower BMI and younger age. During primary lanreotide treated acromegalic patients 60% had no change, 24% had an improvement and 17% had a worsening of glucose status. Deterioration was significantly associated with smaller GH decreases during primary lanreotide treatment.

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Acknowledgments

The authors wish to acknowledge editorial assistance from Watermeadow Medical for clarity of language and formatting to journal requirements, funded by Ipsen. This research did not receive any specific grant from any funding agency in the public, commercial, or not-for-profit sector.

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Authors and Affiliations

  1. Department of Endocrinology and Metabolic Diseases, Pôle Cardio-vasculaire et Métabolique, CHU Rangueil-Larrey, 24 Chemin de Pourvouville, TSA 30030, 31059, Toulouse Cedex 9, France

    Elisabeth Couture, Jean-Christophe Maiza, Antoine Bennet & Philippe Caron

  2. Department of Epidemiology, CHU Rangueil, Toulouse, France

    Vanina Bongard

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  1. Elisabeth Couture
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  2. Vanina Bongard
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  3. Jean-Christophe Maiza
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  5. Philippe Caron
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Correspondence to Philippe Caron.

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Couture, E., Bongard, V., Maiza, JC. et al. Glucose status in patients with acromegaly receiving primary treatment with the somatostatin analog lanreotide. Pituitary 15, 518–525 (2012). https://doi.org/10.1007/s11102-011-0361-9

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