Management of type 2 diabetes mellitus associated with pituitary gigantism.

Abstract

Pituitary gigantism, a condition of endogenous growth hormone (GH) hypersecretion prior to epiphyseal closure, is a rare condition. In the adult condition of GH excess, acromegaly, the occurrence of type 2 diabetes mellitus (T2DM) and diabetic ketoacidosis (DKA) have been reported, with resolution following normalization of GH levels. We report the case of a 16-year-old male with pituitary gigantism due to a large invasive suprasellar adenoma who presented with T2DM and DKA. Despite surgical de-bulking, radiotherapy and medical treatment with cabergoline and pegvisomant, GH and insulin-like growth factor-I (IGF-I) levels remained elevated. However, the T2DM and recurrent DKA were successfully managed with metformin and low-dose glargine insulin, respectively. We review the pathophysiology of T2DM and DKA in growth hormone excess and available treatment options.

• Authors: Omar Ali, Swati Banerjee, Daniel F Kelly, Phillip D K Lee
• Journal: Pituitary (Pituitary) Vol. 10 Issue 4 Pg. 359-64 ( 2007) ISSN: 1386-341X [Print] United States
• PMID: 17629784 (Publication Type: Case Reports, Journal Article)

Chemical References

• Antineoplastic Agents
• Ergolines
• Hypoglycemic Agents
• Insulin
• Insulin, Long-Acting
• Human Growth Hormone
• Insulin Glargine
• Metformin
• Cabergoline
• pegvisomant

Topics

• Adenoma (complications, surgery, therapy)
• Adolescent
• Antineoplastic Agents (therapeutic use)
• Cabergoline
• Combined Modality Therapy
• Diabetes Mellitus, Type 2 (complications, drug therapy)
• Ergolines (therapeutic use)
• Gigantism (complications, surgery, therapy)
• Human Growth Hormone (analogs & derivatives, therapeutic use)
• Humans
• Hypoglycemic Agents (therapeutic use)
• Insulin (analogs & derivatives, therapeutic use)
• Insulin Glargine
• Insulin, Long-Acting
• Male
• Metformin (therapeutic use)
• Pituitary Neoplasms (complications, surgery, therapy)
• Radiotherapy