Long-term Effects of Octreotide Acetate on Glucose Metabolism among Acromegalic Patients

Abstract

Octreotide therapy has proved effective in treating acromegaly. In these patients, a high incidence of impaired glucose tolerance is recognized. Octreotide acetate decreases growth hormone in over 90% of acromegalic patients, but glucose tolerance is not always improved. We studied the long-term effects of octreotide acetate on glucose metabolism among acromegalic patients. AUC glucose and AUC IRI calculated on 75 g OGTT, insulin sensitivity and β-cell function evaluated by HOMA-S and -β, HbA₁c, GH, and IGF-I were assessed in patients eligible for evaluation before and after octreotide therapy. GH and IGF-I decreased significantly with octreotide therapy (p<0.01). HbA₁c worsened significantly after octreotide treatment in diabetic patients diagnosed before octreotide therapy (p<0.05). HOMA-S was unchanged. HOMA-β was significantly reduced (p<0.05) after octreotide therapy. In conclusion, octreotide therapy for acromegalic patients with diabetes mellitus requires careful monitoring of glucose tolerance.