Dysglycemia in patients with Acromegaly and Cushing’s syndrome

Introduction: Acromegaly and Cushing’s syndrome are endocrine disorders associated to frequent metabolic abnormalities. The aim of our study was to assess the prevalence of prediabetes and overt diabetes in patients presenting with acromegaly and Cushing’s syndrome and to find the association between glucose intolerance, age, gender, sex, body mass index, the level of activity of the disease and the duration of symptoms. Patients and methods: This is a retrospective and descriptive review of patient records presenting acromegaly and Cushing’s syndrome. Seventy-eight patients were included. Patients were grouped into normoglycemic and dysglycemic based on fasting blood glucose and hemoglobin A1C. Data of age, sex, gender, levels of fasting blood glucose and hemoglobin A1C were reviewed before and after treatment of acromegaly or Cushing’s syndrome. Results: Major risk factors for dysglycemia included: a mean age of 43 years in acromegaly and 28.6 years in Cushing’s syndrome patients, a male predominance in acromegalic patients and female predominance in Cushing’s syndrome ones, body mass index and duration of disease was higher in dysglycemic Cushing’s syndrome patients. Mean IGF-1 levels were higher among the dysglycemic than normoglycemic acromegalic patients. A decrease in mean HbA1c after surgical or medical treatment was also noted in both patients with Cushing’s syndrome and acromegaly. Conclusion: Dysglycemia in the form of prediabetes and diabetes are frequently observed in patients with acromegaly and hypercortisolism. Early diagnosis of glucose metabolism abnormalities in the course of the disease can decrease complications. Treatment modalities have varied impacts on glucose metabolism.