Diabetes Secondary to Acromegaly: Physiopathology, Clinical Features and Effects of Treatment
Acromegaly is a rare disease due to chronic GH excess and to the consequent increase in IGF-1 levels. Both GH and IGF-1 play a role in intermediate metabolism affecting glucose homeostasis. Indeed, chronic GH excess impairs insulin sensitivity, increases gluconeogenesis, reduces the glucose uptake i...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2018-07-01
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| Series: | Frontiers in Endocrinology |
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| Online Access: | https://www.frontiersin.org/article/10.3389/fendo.2018.00358/full |
| _version_ | 1818422567295254528 |
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| author | Francesco Ferraù Adriana Albani Alessandro Ciresi Carla Giordano Salvatore Cannavò |
| author_facet | Francesco Ferraù Adriana Albani Alessandro Ciresi Carla Giordano Salvatore Cannavò |
| author_sort | Francesco Ferraù |
| collection | DOAJ |
| description | Acromegaly is a rare disease due to chronic GH excess and to the consequent increase in IGF-1 levels. Both GH and IGF-1 play a role in intermediate metabolism affecting glucose homeostasis. Indeed, chronic GH excess impairs insulin sensitivity, increases gluconeogenesis, reduces the glucose uptake in adipose tissue and muscle and alters pancreatic β cells function. As a consequence, glucose metabolism alterations are a very frequent complication in acromegaly patients, further contributing to the increased cardiovascular risk and mortality. Treatment modalities of acromegaly differently impact on glucose tolerance. Successful surgical treatment of acromegaly ameliorates glucose metabolism abnormalities. Drugs used to treat acromegaly patients may per se affect glucose homeostasis, therefore influencing patients' management. Indeed pegvisomant has been shown to positively impact on glucose metabolism, while somatostatin analogs, especially pasireotide, can cause hyperglycaemia. On the other hand, robust data on the effect of dopamine agonists on glycaemic profile are still lacking. This review summarizes the available data on diabetes mellitus in acromegaly patients, with a focus on the potential effects of the medical treatment of the disease on glucose homeostasis, providing an overview of the current state of the art. |
| first_indexed | 2024-12-14T13:28:18Z |
| format | Article |
| id | doaj.art-c48eb7fed16a4a658a812af9f0054606 |
| institution | Directory Open Access Journal |
| issn | 1664-2392 |
| language | English |
| last_indexed | 2024-12-14T13:28:18Z |
| publishDate | 2018-07-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Endocrinology |
| spelling | doaj.art-c48eb7fed16a4a658a812af9f00546062022-12-21T22:59:47ZengFrontiers Media S.A.Frontiers in Endocrinology1664-23922018-07-01910.3389/fendo.2018.00358362604Diabetes Secondary to Acromegaly: Physiopathology, Clinical Features and Effects of TreatmentFrancesco Ferraù0Adriana Albani1Alessandro Ciresi2Carla Giordano3Salvatore Cannavò4Department of Human Pathology of Adulthood and Childhood ‘G. Barresi', University of Messina, Messina, ItalyDepartment of Clinical and Experimental Medicine, University of Messina, Messina, ItalySection of Endocrinology, Diabetology and Metabolism, Biomedical Department of Internal and Specialist Medicine (DIBIMIS), University of Palermo, Palermo, ItalySection of Endocrinology, Diabetology and Metabolism, Biomedical Department of Internal and Specialist Medicine (DIBIMIS), University of Palermo, Palermo, ItalyDepartment of Human Pathology of Adulthood and Childhood ‘G. Barresi', University of Messina, Messina, ItalyAcromegaly is a rare disease due to chronic GH excess and to the consequent increase in IGF-1 levels. Both GH and IGF-1 play a role in intermediate metabolism affecting glucose homeostasis. Indeed, chronic GH excess impairs insulin sensitivity, increases gluconeogenesis, reduces the glucose uptake in adipose tissue and muscle and alters pancreatic β cells function. As a consequence, glucose metabolism alterations are a very frequent complication in acromegaly patients, further contributing to the increased cardiovascular risk and mortality. Treatment modalities of acromegaly differently impact on glucose tolerance. Successful surgical treatment of acromegaly ameliorates glucose metabolism abnormalities. Drugs used to treat acromegaly patients may per se affect glucose homeostasis, therefore influencing patients' management. Indeed pegvisomant has been shown to positively impact on glucose metabolism, while somatostatin analogs, especially pasireotide, can cause hyperglycaemia. On the other hand, robust data on the effect of dopamine agonists on glycaemic profile are still lacking. This review summarizes the available data on diabetes mellitus in acromegaly patients, with a focus on the potential effects of the medical treatment of the disease on glucose homeostasis, providing an overview of the current state of the art.https://www.frontiersin.org/article/10.3389/fendo.2018.00358/fullacromegalydiabetesGHIGF-1pituitary tumorglucose metabolism |
| spellingShingle | Francesco Ferraù Adriana Albani Alessandro Ciresi Carla Giordano Salvatore Cannavò Diabetes Secondary to Acromegaly: Physiopathology, Clinical Features and Effects of Treatment Frontiers in Endocrinology acromegaly diabetes GH IGF-1 pituitary tumor glucose metabolism |
| title | Diabetes Secondary to Acromegaly: Physiopathology, Clinical Features and Effects of Treatment |
| title_full | Diabetes Secondary to Acromegaly: Physiopathology, Clinical Features and Effects of Treatment |
| title_fullStr | Diabetes Secondary to Acromegaly: Physiopathology, Clinical Features and Effects of Treatment |
| title_full_unstemmed | Diabetes Secondary to Acromegaly: Physiopathology, Clinical Features and Effects of Treatment |
| title_short | Diabetes Secondary to Acromegaly: Physiopathology, Clinical Features and Effects of Treatment |
| title_sort | diabetes secondary to acromegaly physiopathology clinical features and effects of treatment |
| topic | acromegaly diabetes GH IGF-1 pituitary tumor glucose metabolism |
| url | https://www.frontiersin.org/article/10.3389/fendo.2018.00358/full |
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