Prevalence and clinical correlates of pre-operative glucose homeostasis in patients with acromegaly.

CONTEXT: Comprehensive assessments of the prevalence of prediabetes and glucose intolerance are scarce for acromegaly.

OBJECTIVE

To estimate the prevalence of pre-operative glucose homeostasis in patients with acromegaly, including diabetes mellitus (DM), impaired fasting glucose, impaired glucose tolerance, and prediabetes.

DESIGN

The study encompassed patients diagnosed with acromegaly at Taipei Veterans General Hospital from 1977 to 2020. Known DM was defined as the use of anti-diabetic medication. Newly diagnosed DM was defined as any of the following conditions: a fasting PG concentration ≥ 126 mg/dL, 2-h glucose concentration ≥ 200 mg/dL during the OGTT, or HbA1c level ≥ 6.5%. Normal glucose tolerance (NGT) was defined as a fasting PG concentration < 100 mg/dL, 2-h glucose concentration < 140 mg/dL during the OGTT, HbA1c level < 5.7%, and not using anti-diabetic medication. Patients who did not meet the criteria for either DM or NGT were classified as having prediabetes.

RESULTS

Of 177 patients, 83 (46.9%) had diabetes-39 pre-existing and 44 newly diagnosed. Normal glucose tolerance (NGT) occurred in 32 patients (18.1%), while 62 (35.0%) had prediabetes. Among those with prediabetes, impaired fasting glucose was noted in 59 (39.3% of those with fasting data), impaired glucose tolerance in 47 (34.3% of those with OGTT data), and HbA1c levels of 5.7-6.4% in 19 (28.0% of those with HbA1c data).

CONCLUSION

Our findings on diagnosis and prevalence of various blood-glucose statuses in patients with acromegaly at the pre-operative stage may suggest novel mechanisms worthy of further investigation.