• Users Online: 341
  • Print this page
  • Email this page
CASE REPORTS
Year : 2021  |  Volume : 12  |  Issue : 1  |  Page : 101-104

A challenge to achieve glycemic control in a patient with diabetes mellitus


1 Department of Endocrinology, AIIMS, Rishikesh, Uttarakhand, India
2 Department of Medicine, Division of Diabetes and Metabolism, AIIMS, Rishikesh, India
3 Department of Medicine, AIIMS, Rishikesh, Uttarakhand, India

Correspondence Address:
Dr. Nisha Batra
Department of Endocrinology, AIIMS, Rishikesh, Uttarakhand 249203.
India
Login to access the Email id

Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jod.jod_15_20

Rights and Permissions

Secondary diabetes mellitus (DM) is a known identity with multiple causes. Acromegaly, a state of growth hormone (GH) excess, is a rare but an established cause of DM. Dysglycemia is present in approximately 50% of patients of acromegaly with impaired glucose tolerance (IGT) or impaired fasting glucose (IFG) ranging from 6% to 45% and from 7% to 22%, respectively, and DM has been reported in 16%–56% of patients (Alexopoulou O, Bex M, Kamenicky P, Mvoula AB, Chanson P, Maiter D. Prevalence and risk factors of IGT and DM at diagnosis of acromegaly: A study in 148 patients. Pituitary 2014;17:81-9; Dal J, Feldt-Rasmussen U, Andersen M, Kristensen LØ, Laurberg P, Pedersen L, et al. Acromegaly incidence, prevalence, complications and long-term prognosis: A nationwide cohort study. Eur J Endocrinol 2016;175:181-90). Diabetes in these patients is usually severe and difficult to treat. Glycemic control in these patients is best achieved by treating the underlying GH excess. We report a 60-year-old female patient, case of somatotropinoma, who was referred to diabetic clinic in view of persistent hyperglycemia despite taking multiple antidiabetic medications along with high-dose basal-bolus insulin regimen. Patient had residual pituitary tumor with GH excess and clinically active disease. She was started with somatostatin analogs for the residual disease. Her blood sugar values improved dramatically with episodes of hypoglycemia in between. Patient was shifted to single oral hypoglycemic (OHA) along with low dose insulin. This case highlights the direct association between GH excess and its hyperglycemic effects. Following successful treatment of acromegaly with surgery, irradiation, or medical management, glucose tolerance improves; although complete resolution is rare, OHA/insulin requirement is dramatically reduced.


[FULL TEXT] [PDF]*
Print this article     Email this article
 Next article
 Previous article
 Table of Contents

 Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
 Related articles
 Citation Manager
 Access Statistics
 Reader Comments
 Email Alert *
 Add to My List *
 * Requires registration (Free)
 

 Article Access Statistics
    Viewed160    
    Printed4    
    Emailed0    
    PDF Downloaded23    
    Comments [Add]    

Recommend this journal