Management of type 2 diabetes mellitus associated with pituitary gigantism

Omar Ali, Swati Banerjee, Daniel F. Kelly, Phillip D.K. Lee

Research output: Contribution to journalArticle

13 Scopus citations

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.

Original languageEnglish (US)
Pages (from-to)359-364
Number of pages6
JournalPituitary
Volume10
Issue number4
DOIs
StatePublished - Dec 1 2007
Externally publishedYes

Keywords

  • Diabetes mellitus
  • Diabetic ketoacidosis
  • Growth hormone
  • Metformin
  • Pituitary gigantism

ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism
  • Endocrinology

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