Vnitr Lek 2025, 71(2):E6-E12 | DOI: 10.36290/vnl.2025.023

Secondary diabetes mellitus in acromegaly

Ivana Ságová^{1, 2}, Tomáš Bolek², Matej Samoš², Daniela Kantárová², Jakub Benko^{2, 3}, Martin Jozef Péč², Jakub Jurica², Ingrid Tonhajzerová⁴, Marián Mokáň²

¹ Endokrinologické oddelenie, Národný endokrinologický a diabetologický ústav Ľubochňa

² 1. interná klinika UN a JLF UK, Martin

³ Kardiologická klinika, Fakultná nemocnica, Nitra

⁴ Ústav fyziológie, JLF UK, Martin

Acromegaly is a rare endocrine disorder characterized by the overproduction of growth hormone (GH), most commonly due to a pituitary adenoma, leading to increased production of insulin-like growth factor 1 (IGF-1) in the liver. The effects of GH and IGF-1 on glucose metabolism are antagonistic; GH induces insulin resistance, while IGF-1 enhances insulin sensitivity. However, the insulin-antagonizing effect of GH outweighs the insulin-sensitizing effect of IGF-1 in target tissues, leading to the development of diabetes mellitus (DM) in acromegaly.Secondary DM is a frequent complication in patients with acromegaly. In fact, DM may be the first manifestation of the disease, because hyperglycemia caused by insulin resistance is often significant. The diagnosis and management of DM in patients with acromegaly are complex and require a multidisciplinary approach involving endocrinologists, diabetologists, and other specialists. Effective control of acromegaly through surgery, pharmacotherapy, or radiotherapy can improve glucose homeostasis and reduce the risk of complications associated with DM. This review article discusses the pathophysiological and clinical characteristics of DM in patients with acromegaly, as well as the potential effects of specific acromegaly treatments on glucose homeostasis.

Keywords: acromegaly, diabetes mellitus, insulin resistance, growth hormone.

Accepted: March 18, 2025; Published: March 27, 2025  Show citation