title: Resection of Pheochromocytoma Improves Diabetes Mellitus in the Majority of Patients.
abstract: BACKGROUND
  Catecholamine excess in patients with pheochromocytoma often results in impaired glucose tolerance, leading to diabetes mellitus. Little data are available on the long-term effect of surgery on diabetes.
  
  
  OBJECTIVE
  The primary aim of this study was to determine the likelihood of diabetes cure after surgery, while secondary objectives were to determine risk factors for development of diabetes preoperatively and persistence of diabetes postoperatively.
  
  
  METHODS
  All patients undergoing surgery for pheochromocytoma from 1996 to 2015 were retrospectively reviewed to identify those with a preoperative diagnosis of diabetes. Demographic and diabetes-specific data were collected. Median follow-up was 52.1 months.
  
  
  RESULTS
  Overall, 153 patients underwent surgery. Diabetes was seen in 36 (23.4%) patients. Eight patients met the exclusion criteria and were removed from the final analysis, while 22 (78.6%) patients had complete resolution of diabetes. Four patients remained on medication with improved control. Overall, 93.0% of patients had improvement of their diabetes; two patients did not improve. Patients with large, symptomatic tumors were more likely to develop preoperative diabetes, and diabetes was more likely to persist in patients who had an elevated body mass index (BMI).
  
  
  CONCLUSIONS
  Diabetes was found concurrently with pheochromocytoma in 23% of patients, more often in those with large, symptomatic tumors. The majority of patients had long-term resolution of diabetes after successful resection; however, some patients may continue to require treatment of diabetes after operation, especially those with a higher BMI.
authors.affiliation: Department of Surgery, University of California, San Francisco, CA, USA.|Department of Surgery, New York Presbyterian Hospital-Weill Cornell Medicine, New York, NY, USA.
authors.forename: Toni
authors.initials: T
authors.lastname: Beninato
authors.affiliation: Department of Surgery, University of California, San Francisco, CA, USA.|Department of Surgery, University Medical Center Utrecht, Utrecht, The Netherlands.
authors.forename: Wouter P
authors.initials: WP
authors.lastname: Kluijfhout
authors.affiliation: Department of Surgery, University of California, San Francisco, CA, USA.|Department of Surgery, Boston University School of Medicine, Boston, MA, USA.
authors.forename: Frederick Thurston
authors.initials: FT
authors.lastname: Drake
authors.affiliation: Department of Surgery, University of California, San Francisco, CA, USA.
authors.forename: James
authors.initials: J
authors.lastname: Lim
authors.affiliation: Department of Surgery, University of California, San Francisco, CA, USA.
authors.forename: Julie S
authors.initials: JS
authors.lastname: Kwon
authors.affiliation: Department of Surgery, University of California, San Francisco, CA, USA.
authors.forename: Maggie
authors.initials: M
authors.lastname: Xiong
authors.affiliation: Department of Surgery, University of California, San Francisco, CA, USA.
authors.forename: Wen T
authors.initials: WT
authors.lastname: Shen
authors.affiliation: Department of Surgery, University of California, San Francisco, CA, USA.
authors.forename: Jessica E
authors.initials: JE
authors.lastname: Gosnell
authors.affiliation: Department of Medicine, Division of EndocrinologyUniversity of California, San Francisco, CA, USA.
authors.forename: Chienying
authors.initials: C
authors.lastname: Liu
authors.affiliation: Department of Surgery, University of California, San Francisco, CA, USA.
authors.forename: Insoo
authors.initials: I
authors.lastname: Suh
authors.affiliation: Department of Surgery, University of California, San Francisco, CA, USA. quan-yang.duh@ucsf.edu.
authors.forename: Quan-Yang
authors.initials: QY
authors.lastname: Duh
mesh_terms: D000293:Adolescent; D000310:Adrenal Gland Neoplasms / Q000453:epidemiology* / Q000473:pathology / Q000601:surgery*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001786:Blood Glucose; D015992:Body Mass Index; D015897:Comorbidity; D003920:Diabetes Mellitus / Q000097:blood / Q000188:drug therapy / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D010673:Pheochromocytoma / Q000453:epidemiology* / Q000473:pathology / Q000601:surgery*; D011184:Postoperative Period; D057234:Preoperative Period; D012189:Retrospective Studies; D012307:Risk Factors; D047368:Tumor Burden; D055815:Young Adult
chemical_list: D001786:Blood Glucose