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Diabetes in Patients With Acromegaly

  • Other Forms of Diabetes and Its Complications (JJ Nolan, Section Editor)
  • Published:
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Abstract

Purpose of Review

Acromegaly is a clinical syndrome which results from growth hormone excess. Uncontrolled acromegaly is associated with cardiovascular mortality, due to an excess of risk factors including diabetes mellitus, hypertension and cardiomegaly. Diabetes mellitus is a frequent complication of acromegaly with a prevalence of 12–37%. This review will provide an overview of a number of aspects of diabetes mellitus and glucose intolerance in acromegaly including the following:

  1. 1.

    Epidemiology and pathophysiology of abnormalities of glucose homeostasis

  2. 2.

    The impact of different management options for acromegaly on glucose homeostasis

  3. 3.

    The management options for diabetes mellitus in patients with acromegaly

Recent Findings

Growth hormone and IGF-1 have complex effects on glucose metabolism. Insulin resistance, hyperinsulinaemia and increased gluconeogenesis combine to produce a metabolic milieu which leads to the development of diabetes in acromegaly. Treatment of acromegaly should ameliorate abnormalities of glucose metabolism, due to reversal of insulin resistance and a reduction in gluconeogenesis. Recent advances in medical therapy of acromegaly have varying impacts on glucose homeostasis. These adverse effects influence management choices in patients with acromegaly who also have diabetes mellitus or glucose intolerance.

Summary

The underlying mechanisms of disorders of glucose metabolism in patients with acromegaly are complex. The aim of treatment of acromegaly is normalisation of GH/IGF-1 with reduction of co-morbidities. The choice of therapy for acromegaly should consider the impact of therapy on several factors including glucose metabolism.

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Authors and Affiliations

  1. Department of Endocrinology, Beaumont Hospital and RCSI Medical School, Beaumont, Dublin 9, Ireland

    A. M. Hannon & C. J. Thompson

  2. Department of Endocrinology, Adelaide and Meath Hospitals incorporating the National Children’s Hospital and Trinity College Dublin, Tallaght, Dublin 24, Ireland

    M. Sherlock

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  1. A. M. Hannon
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  2. C. J. Thompson
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  3. M. Sherlock
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Correspondence to M. Sherlock.

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Conflict of Interest

A.M. Hannon reports grants from Pfizer and Royal College of Surgeons Ireland.

C.J. Thompson reports grants from Pfizer.

M. Sherlock has received research funding from Pfizer and Novartis.

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This article does not contain any studies with human or animal subjects performed by any of the authors.

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This article is part of the Topical Collection on Other Forms of Diabetes and Its Complications

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Hannon, A.M., Thompson, C.J. & Sherlock, M. Diabetes in Patients With Acromegaly. Curr Diab Rep 17, 8 (2017). https://doi.org/10.1007/s11892-017-0838-7

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