Diabetes Mellitus, Chronic Complication In Patients With Acromegaly: Case Report And Review Of The Literature

Disturbances of glucose metabolism are frequently observed in patients with acromegaly. Excess amounts of GH and IGF1 interacts with metabolic regulation, and indeed, GH hypersecretion is associated with hepatic and peripheral insulin resistance; this and also other mechanisms are involved in the development of diabetes mellitus. It can quickly improve if the levels of GH decline after the therapy. Case report: We present a patient of 54 years old, admitted in the clinic in 2009, with diagnosis of acromegaly. MRI scan reveals an expansive pituitary tumor 15/16/17 mm. Values of GH, IGF1 and blood glucose were much above normal. Body mass index 27, 5 kg/m(2). After 12 months of a medical treatment with somatostatin analogues, the evolution of blood parameters was favorable, but the patient has discontinued his treatment. At the hospitalization in 2012 there is a precarious control of the diabetes under oral antidiabetic agents. A new treatment has been applied: it was practiced surgical transsphenoidal ablation. At last admit, May 2014, the value IGF1 has been normal, GH has been below 1 ng/mL, and HbA1c was 5.27%. Dyslipidemic syndrome has been constantly present; the values of triglycerides and cholesterol should be a little more upper limit. Conclusions: Following successful treatment of acromegaly with surgery, glucose tolerance improves. Balancing type 2 diabetes, with return to normal HbA1c and the decrease in cholesterol and triglycerides values, represents the result of favorable normalization GH in our patients with acromegaly.