STUDIES ON THE PATHOGENESIS OF DIABETES IN ACROMEGALY

Abstract

Plasma insulin response to glucose infusion was found to be markedly increased in 20 patients with active acromegaly and with normal intravenous glucose tolerance. The insulin response was more pronounced in patients with highly active acromegaly than in those showing moderately active disease. In 5 patients with active acromegaly and with decreased glucose tolerance the insulin response was delayed and smaller than normal, i.e. similar to that seen in diabetic subjects without acromegaly. After successful treatment of the acromegaly insulin response to glucose infusion was normalized in the patients with normal glucose tolerance. In those with decrease glucose tolerance the diabetic type of insulin response remained unchanged even when the glucose tolerance was normalized. Diabetes in connection with acromegaly may develop only in prediabetic individuals, i.e. subjects with decreased insulin response to hyperglycemia, who are unable to overcome the diabetogenic effect of growth hormone by compensatory hyper insulinism.