Glucose homeostasis in patients with acromegaly treated with surgery or somatostatin analogues

Abstract

Control of acromegaly with either TSS or SSA improved insulin sensitivity as evident by significantly lower fasting and postglucose insulin levels and HOMA-IR. In addition, patients of group III compared to patients of group II demonstrated significantly lower HOMA-β% (52·5 ± 10·9 vs 189·6 ± 86·7, P < 0·05) and lower first and second phase insulin release (443 ± 83·5 vs 1077 ± 140·8, P < 0·05 and 150 ± 18·2 vs 285 ± 33·3, P < 0·05), respectively. Also, lower fasting glucose levels and a lower prevalence of diabetes were noted in group II compared to group III (5·1 ± 0·2 vs 6·2 ± 0·2 mm, P < 0·05, and 13·3%vs 40%, P < 0·0031, respectively). CONCLUSIONS; Control of acromegaly with SSA seems to exhibit a negative effect on pancreatic β-cell function. Whether this has long-term clinical implications remains to be established. Nevertheless, careful monitoring of glucose metabolism in patients under SSA is beneficial for their optimal management.