Diabetic ketoacidosis in acromegaly; a rare complication precipitated by corticosteroid use. (December 2017)

• Record Type: Journal Article
• Authors: Weiss, Jeremy; Wood, Anna J.; Zajac, Jeffrey D.; Grossmann, Mathis; Andrikopoulos, Sofianos; Ekinci, Elif I.
• Is Part Of: Diabetes research and clinical practice. Volume 134(2017)
• Page Start: 29
• Page End: 37
• Publication Date: 2017-12
• Subjects: Acromegaly -- Ketoacidosis -- Diabetes -- Corticosteroids -- Somatostatin analogues; Diabetes -- Periodicals; Diabetes Mellitus -- Periodicals; 616.462
• DOI: 10.1016/j.diabres.2017.08.023
• Languages: English
• ISSNs: 0168-8227

Abstract

Highlights: Patients with acromegaly are susceptible to developing diabetes and diabetic ketoacidosis. Medications used in the treatment of acromegaly may precipitate diabetic ketoacidosis. Glucose monitoring is necessary for patients with acromegaly who are commenced on high dose steroids. Diabetic ketoacidosis in acromegaly does not usually necessitate long term insulin therapy. Abstract: Diabetic ketoacidosis has been described in the literature as a rare possible initial presentation of acromegaly before a diagnosis of acromegaly is eventually made. Indeed, diabetic ketoacidosis is a recognised complication of acromegaly. There are a number of factors that can predispose patients with acromegaly to diabetes as well as to diabetic ketoacidosis. These include high levels of growth hormone and insulin-like growth factor 1 in acromegaly and the effect on glycaemia by medications used in the management of acromegaly. Ketoacidosis has been described in patients with acromegaly even without the presence of an underlying autoimmune diabetes. Patients with acromegaly and ketoacidosis often respond to treatment and may not require long-term insulin.