Correa LL, Taboada GF, Van Haute FR, Casini AF, Balarini GA, Vieira Neto L, Machado EDO, Fontes R, Andrade CCD, Schrank Y, Gadelha MR. [Evaluation of glucose metabolism in acromegalic patients before and after treatment with octreotide LAR].
ACTA ACUST UNITED AC 2009;
52:55-64. [PMID:
18345397 DOI:
10.1590/s0004-27302008000100009]
[Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2007] [Accepted: 10/30/2007] [Indexed: 11/21/2022]
Abstract
AIM OF THE STUDY
To evaluate the glucose metabolism in acromegalic patients before and after treatment with octreotide LAR.
PATIENTS AND METHODS
This was a prospective and longitudinal study involving 30 patients from the acromegaly research outpatient clinic of the Endocrinology unit of the HUCFF/UFRJ. They underwent clinical and laboratorial evaluations, with measurements of growth hormone (GH), insulin-like growth factor type I (IGF-I), insulin, proinsulin, C peptide, glycosylated hemoglobin (HbA1c), IGF binding protein type 1 (IGFBP-1) and glucose, during oral glucose tolerance test (OGTT), before and after six months of treatment with octreotide LAR. The Wilcoxon signed-rank test was used and values of 5% were considered statistically significant.
RESULTS
We found 16 (54%) patients with normal glucose tolerance, 7 (23%) with impaired glucose tolerance and 7 (23%) diabetics. Twelve patients completed the six-month treatment, out of which three showed worsening of glucose tolerance and two (diabetics) had worse blood glucose control. Whereas there was an increase in waist circumference (p=0.03), there was a decrease in GH (p=0.04), with %IGF-I above the upper limit of reference values (% ULRV) [p=0.001], insulin (p=0.019), C peptide levels (p=0.002) and homeostatic model assessment (HOMA-IR) [p=0.039].
CONCLUSIONS
In this series, treatment with octreotide LAR led to a worsening of glucose tolerance in three non-diabetic patients and worsened glycemic control in two diabetics, in spite of reducing insulin resistance.
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