Endocrine Abstracts

Objective: The impact of first-line somatostatin analogues (SSA) on glucose tolerance in acromegaly was investigated during a 10 year period.

Patients: One hundred and twelve patients treated with depot SSA.

Outcome measures: Primary outcome measures were fasting glucose levels. Data were analyzed according with baseline glucose tolerance and disease control.

Results after 12 months SSA treatment: In the 63 patients with normal glucose tolerance (NGT) at baseline, fasting glucose levels did not change but in the 26 controlled patients were lower than in the 37 uncontrolled (P=0.019). All controlled patients had NGT while 13 of uncontrolled patients were receiving treatment with metformin. In the 24 patients with impaired fasting glucose (IFG) or impaired glucose tolerance (IGT) at baseline, fasting glucose levels were lower than pre-treatment levels (P=0.0023) and in the 14 controlled patients were significantly lower than in the 10 uncontrolled (P=0.012). Eight patients remained IFG or IGT at study end (33.3%), 16 patients had NGT (66.6%) (8 because of metformin treatment). In the 25 patients with diabetes mellitus at baseline, fasting glucose levels were lower than pre-treatment (P<0.0001) and in the 14 controlled patients were significantly lower than in the 11 uncontrolled (P=0.007). At study end, 74 patients had NGT (66.1%), 11 had IGT (9.8%) and 21 had DM (18.7%). Changes in glucose tolerance (improvements in 20 patients (17.8%) and worsening in 13 patients (15.2%)) were correlated with achievement or not of disease control. Mean GH levels were the most important predictors of 12 months fasting glucose (t=2.73; P=0.0076).

Conclusions: This study demonstrated a non significant worsening of glucose tolerance 12 months after SSA treatment given as first-line. Deterioration glucose tolerance was associated with uncontrolled acromegaly during treatment.