Glycemic disorders in patients with pheochromocytomas and sympathetic paragangliomas.

The objective of our study was to determine de prevalence of glycemic disorders (diabetes mellitus and prediabetes) in patients with pheochromocytomas and sympathetic paragangliomas (PPGLs) and identify risk factors for their development and the likelihood of their resolution after surgery. A multicentric retrospective study of patients with PPGLs submitted to surgery between 2000-2021 in seventeen Spanish hospitals was performed. Diabetes-specific data were collected at diagnosis, in the immediate and long-term postsurgical follow-up. A total of 229 patients with PPGLs were included (218 with pheochromocytomas and 11 with sympathetic paragangliomas). Before surgery, glycemic disorders were diagnosed in 35.4% of the patients (n=81): 54 with diabetes and 27 with prediabetes. The variables independently associated with a higher risk of glycemic disorders were sporadic PPGL (OR=3.26 [1.14-9.36]) and hypertension (OR=3.14 [1.09-9.01]). A significant decrease in fasting plasma glucose and HbA1c levels was observed after surgery, in the short-term and long-term follow up (P<0.001). After a median follow-up of 48.5 months [range 3.3 to 168.9], after surgery, 52% of diabetic and 68% of prediabetic patients experienced a complete resolution. Lower BMI (P=0.001), lower glucose levels (P=0.047) and shorter duration of diabetes prior to surgery (P=0.021) were associated with a higher probability of diabetes resolution. In conclusion, glycemic disorders in patients with PPGLs are present in more than a third of them at diagnosis. Sporadic PPGL and hypertension are risk factors for their development. More than 50% of the cases experienced a complete resolution of the glycemic disorder after the resection of the PPGL.