Concomitant type 2 diabetes increases mortality and morbidity risk in acromegaly patients

Sweden: Coexistence of diabetes increases the risk of overall mortality as well as cardiovascular mortality and morbidity in patients with acromegaly, states a study article published in the Journal of Clinical Endocrinology and Metabolism.

Acromegaly is a hormonal disorder caused by excess secretion of growth hormone (GH), generally, from the pituitary gland, that results in increased levels of insulin-like growth factor 1 (IGF-1). Chronic excess of IGF-1 leads to systemic comorbidities and increased mortality, mainly due to cardiovascular diseases. The goals for the treatment of acromegaly are therefore to achieve biochemical remission and to treat associated comorbidities. Impaired glucose metabolism is a common complication in acromegaly and the prevalence of diabetes mellitus ranges between 19% and 56% in patients with acromegaly. The incidence of diabetes in acromegaly is mainly driven by insulin resistance. Diabetes is a major risk factor for cardiovascular disease and death but its effect on outcomes in acromegaly is unknown.

Daniela Esposito, University of Gothenburg, Sweden, and colleagues conducted a study to determine whether diabetes affects morbidity and mortality in patients with acromegaly.

Investigators conducted a nationwide (Sweden), observational, matched-cohort study. The study included 254 patients with acromegaly and concomitant type 2 diabetes (ACRO-DM group) and 532 without diabetes (ACRO group). . The risk of overall mortality and cardiovascular mortality and morbidity were estimated using Cox regression. Overall, the mean follow-up was 9.2 years.