Endocrine Abstracts

Context: Acromegaly is chronic insidious disease caused by excessive GH secretion by pituitary adenoma. This leads to overproduction of IGF1 and serious disseminated concequences.

Material: 14 acromegalic subjects with diagnosed insulin dependent diabetes on stable octreotide LAR) treatment. Patients did not meet recent criteria of biochemical controlled disease (mean GH 4.6 ng/ml, mean IGF1 2.2-fold upper normal limit).

Methods: Patients were recruited from clinical outpatient database. All glucose self-assessments during three years of observation was captured to include into a database (18 862 assessments). Somatostatin analogue injections were recorded. GH, IGF1, and HbA1c assessments were performed every 3 months.

Results: In whole group over observation period there were increased HbA1c percentage (mean 7.2% SD 1.3 to 7.4% SD 1.6), however insignificant and stable during somatostatin analogue (SA) therapy. Insulin consumption did not increase significantly during observation.

Mean fasting glucose concentrations were stable during therapy. We did not observe fluctuations correlated with intra-injection periods. Mean fasting glucose did not differ pre-injection and 2 weeks after SA injection. Postprandial glucose did not differ significantly throughout post-injection period. We did not see any non-linear correlations between the day after injection and glucose concentrations.

Conclusions: During stable somatostatin analogue treatment in diabetic acromegalic patients, glucose control did not changes during post-injection period. This is additional proof of relatively low fluctuations of SA action during treatment.