EFFECT OF OCTREOTIDE ON GLUCOSE-TOLERANCE IN ACROMEGALY

To determine the effect of the somatostatin analog octreotide on gluco se tolerance in acromegaly, we examined glucose profiles, oral glucose tolerance and the insulinogenic index in patients treated with this a nalog. Ninety patients participated in a long-term, prospective, open- label study. There was no significant change between mean daily blood glucose profiles at baseline or during octreotide treatment. Using glu cose tolerance test criteria, 61% of 90 patients had normal baseline g lucose tolerance. While on octreotide, 20% and 29% of these patients, respectively, developed impaired glucose tolerance or became frankly d iabetic. Conversely three of the patients who were diabetic at baselin e (N = 11) became normal (18%) or developed impaired glucose tolerance (9%) during octreotide therapy. There was no relationship between the dose of octreotide and change in glycemic state. The insulinogenic in dex (insulin/glucose) response to a glucose challenge decreased unifor mly in octreotide-treated patients. Female patients and those with ele vated baseline insulin levels were more likely to develop diabetes mel litus during octreotide therapy. In conclusion, octreotide significant ly alters glucose tolerance in patients with acromegaly, mandating glu cose monitoring during this form of therapy.