Endocrine Abstracts

Introduction: The clinical significance of the impact of GH on glucose homeostasis in adults with GH deficiency (GHD) remains unclear. We report the impact of 4 years of continuous GH therapy on HbA1c and progression to diabetes.

Methods: Data were analysed from patients with adult-onset GHD (>20 years old) enrolled in NordiNet^® International Outcome Study (IOS) (NCT00960128), an observational study, and treated with GH (Norditropin^®, Novo Nordisk A/S, Denmark) for 4 years. Change in HbA1c (ΔHbA1c) from baseline was calculated for all patients, by GH dose group (≤0.2 and >0.2 mg/day), for patients with clinically relevant decrease in HbA1c (≥0.3% decrease), unchanged, or clinically relevant increase in HbA1c (≥0.3% increase), and by baseline health status (% patients) (low–normal, HbA1c <5.8% (75.2%); pre-diabetes/high–normal, HbA1c 5.8–<6.5% (17.3%); diabetes, HbA1c ≥6.5% (7.5%)).

Results: Among the 278 patients (48% females) mean±S.D. age was 49.4±14.5 years, BMI, 29.0±6.1 kg/m² and HbA1c 5.29±0.85%. Patients receiving ≤0.2 mg/day GH (n=120) were older than those receiving >0.2 mg/day GH (53.9 years vs 46.0 years). At 4 years, 54.32% of patients had no change, 20.14% a decrease and 25.54% an increase in HbA1c. ΔHbA1c at 4 years was greater for patients receiving ≤0.2 than >0.2 mg/day GH (0.10±0.61% vs −0.20±0.56%). A significant association (P=0.045) between GH dose >0.2 mg/day and the proportion of patients with clinically significant decrease in HbA1c (≥0.3% vs baseline) was observed. After 4 years, among patients with pre-diabetes/high–normal HbA1c at baseline (n=48), 48% had low–normal HbA1c, 10% developed diabetes, and 42% were unchanged. No overall association between change in health status (baseline to 4 years) and GH dose was found.

Conclusions: Four years of GH therapy was not associated with deterioration in HbA1c or progression to diabetes. Indeed, almost half of patients with pre-diabetes/high–normal HbA1c showed a clinically relevant improvement in health status after 4 years of GH therapy.

Disclosure: This study was sponsored by Novo Nordisk Health Care AG.