Deterioration of glycemic control during octreotide LAR treatment in an acromegalic Japanese patient with type 2 diabetes mellitus.
We report a case showing deterioration of glycemic control during octreotide long-acting release (LAR) treatment in an acromegalic Japanese patient with type 2 diabetes mellitus. The patient did not show much improvement of insulin sensitivity (QUICKI; 0.33 before treatment, 0.35 during octreotide LAR treatment), and showed a significant reduction in early insulin secretion (insulinogenic index; 0.28 before treatment, 0.08 during octreotide LAR treatment) on 75 g oral glucose tolerance test (75gOGTT), despite decreases in GH and IGF-I levels during the course of octreotide LAR treatment. Postoperatively, both insulin sensitivity and early insulin secretion on 75gOGTT were improved (QUICKI 0.59, insulinogenic index 0.35). There are some reports that insulinogenic index is lower in most Japanese patients with type 2 diabetes mellitus and that early insulin secretions are significantly suppressed after administration of octreotide LAR. Although the influence of octreotide LAR on glucose metabolism varies among individuals, it is necessary to manage the deterioration of glucose tolerance during octreotide LAR treatment in acromegalic Japanese patients with decreased insulinogenic index.
Kahara
Toshio
T
Department of Internal Medicine, Toyama Prefectural Central Hospital, Japan.
Ueno
Keiko
K
Torita
Muneyoshi
M
Usuda
Rika
R
Abe
Takumi
T
D000172:Acromegaly / Q000150:complications* / Q000188:drug therapy* / Q000208:ethnology / Q000209:etiology; D044466:Asian People; D001786:Blood Glucose / Q000378:metabolism*; D003692:Delayed-Action Preparations; D003924:Diabetes Mellitus, Type 2 / Q000097:blood* / Q000150:complications* / Q000178:diet therapy / Q000503:physiopathology; D003927:Diet, Diabetic; D005260:Female; D005951:Glucose Tolerance Test; D006801:Humans; D007328:Insulin / Q000378:metabolism; D000078790:Insulin Secretion; D008875:Middle Aged; D015282:Octreotide / Q000009:adverse effects* / Q000627:therapeutic use; D010911:Pituitary Neoplasms / Q000150:complications / Q000601:surgery; D016896:Treatment Outcome
D001786:Blood Glucose; D003692:Delayed-Action Preparations; D007328:Insulin; D015282:Octreotide