AN ASSESSMENT OF GLUCOSE INTOLERANCE IN ACROMEGALY AND ITS RESPONSE TO MEDICAL TREATMENT

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Abstract
Summary: The prevalence of abnormal carbohydrate tolerance has been assessed in sixty‐nine acromegalic patients using six different criteria for the definition of diabetes mellitus. Family history, HLA status and the incidence of pancreatic islet cell antibodies have been documented and the effect of 3 months therapy with bromocriptine on oral glucose tolerance has been assessed in sixty‐one patients.Thirteen patients (18–8%) had clinical diabetes and a total of twenty‐six patients (377%) had asymptomatic diabetes as defined by the British Diabetic Association criteria of 1964. Implementing the 1978 recommendations of the British Diabetic Association, 130% were defined as diabetic. The incidence of a positive family history of diabetes was the same in the diabetic and non‐diabetic acromegalics. There was no disturbance in respect of any of the HLA antigens when this was considered for the number of specificities tested for, and no patient had pancreatic islet cell antibodies.On treatment with bromocriptine, there was a highly significant improvement in the glucose tolerance of both the diabetic (P <0.0001) and the non‐diabetic (P < 0.005) acromegalics. However, in the group of eleven patients with no reduction of serum growth hormone on treatment, no improvement in glucose tolerance was seen.It is concluded that bromocriptine, by directly reducing serum growth hormone, has a significant effect on carbohydrate metabolism in acromegaly, irrespective of the initial level of glucose tolerance.