Endocrine Abstracts

Introduction: Hyperglycaemia occurs frequently in catecholamine-secreting tumours due to insulin suppression or induced insulin resistance. These changes can be reversible postoperatory (postOp).

Objective: Our study aims to establish the impact of surgery in patients with catecholamine-secreting tumours upon glucose metabolism disorders, as well as the predictive factors for postOp diabetes-free patients.

Methods: We retrospectively analysed 72 patients (46 women-26 men), mean age 48 years (9–82), median body mass index 24.5 kg/m² (16–36.19), 66 with pheochromocytoma, 6 with paraganglioma, 3 malignant, 12 known with genetic syndromes. We evaluated their glycaemic status preoperatory (preOp), and for 64 of them postOp, with a median follow-up of 4.17 years. Glucose metabolism disorders were diagnosed according to World Health Organization criteria.

Results: We found preOp diabetes mellitus (DM) in 32 patients (44.44%). We identified significant glycaemic changes in older patients, with longer hypertensive period, higher frequency of metabolic syndrome, adrenal tumours rather than ectopic, and a higher level of ChromograninA (P<0.05). PostOp, 66.6% of patients were free of DM, 30% of them starting from week one postOp. We found significantly more cases of remnant DM in patients with longer duration of preOp DM (P=0.0004, 110-vs-10 months) and in those requiring insulin preOp (P=0.005). Patients with or without postOp DM did not differ in presence of metabolic syndrome (but all patients with remnant DM had metabolic syndrome), history of familial DM, tumour characteristics, clinical or laboratory findings.

Conclusions: Our study found that DM is associated frequently with catecholamine-secreting tumours and 2 thirds disappear postOp. Remnant DM suggests that DM associated with catecholamine-secreting tumours is not always a secondary DM. A longer duration of preOp DM and the fact that the glycaemic control is obtained with insulin upon tumour diagnosis are predictive factors for remnant DM.