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Treatment of acromegaly-induced diabetes: an updated proposal.
Pituitary
December 2024
Endocrinology & Nutrition Department, Hospital Universitario Germans Trias i Pujol. CIBERER U747 (ISCIII), Universitat Autònoma de Barcelona, Badalona, Spain.
Acromegaly-induced diabetes presents unique features due to the direct effects of excess growth hormone (GH) and insulin-like growth factor 1 (IGF-) on glucose metabolism, especially insulin resistance in association to low body fat content and water retention. Increased cardiovascular risk is much higher when acromegaly is complicated with diabetes, thus requiring a holistic management that addresses also these specific characteristics which differ from those of classical type 2 diabetes.The optimal management of diabetes in acromegaly requires not only an effective control of carbohydrate disturbances per se, but also the concurrent control of GH hypersecretion as it will directly impact on glucose control.
View Article and Find Full Text PDFInhibition of somatostatin enhances the long-term metabolic outcomes of sleeve gastrectomy in mice.
Mol Metab
August 2024
Dept. of Developmental Biology and Cancer Research, Institute for Medical Research Israel-Canada, Faculty of Medicine, The Hebrew University of Jerusalem, Jerusalem, Israel; The Center for Computational Medicine, Faculty of Medicine, The Hebrew University of Jerusalem, Jerusalem, Israel. Electronic address:
Objective: Bariatric surgery is an effective treatment to obesity, leading to weight loss and improvement in glycemia, that is characterized by hypersecretion of gastrointestinal hormones. However, weight regain and relapse of hyperglycemia are not uncommon. We set to identify mechanisms that can enhance gastrointestinal hormonal secretion following surgery to sustain weight loss.
View Article and Find Full Text PDFPredictive factors and the management of hyperglycemia in patients with acromegaly and Cushing's disease receiving pasireotide treatment: analyses from the SOM230B2219 study.
Front Endocrinol (Lausanne)
April 2024
Departments of Medicine and Neurologic Surgery, Mayo Clinic, Jacksonville, FL, United States.
Introduction: Pasireotide, a somatostatin receptor ligand, is approved for treating acromegaly and Cushing's disease (CD). Hyperglycemia during treatment can occur because of the drug's mechanism of action, although treatment discontinuation is rarely required. The prospective, randomized, Phase IV SOM230B2219 (NCT02060383) trial was designed to assess optimal management of pasireotide-associated hyperglycemia.
View Article and Find Full Text PDFTreatment of short bowel syndrome: Breaking the therapeutic ceiling?
Nutr Clin Pract
May 2023
Department of Gastroenterology and Nutrition Support, Assistance Publique des Hopitaux de Paris, University of Paris, Clichy, France.
Short bowel syndrome (SBS) is the most common cause of chronic intestinal failure, requiring home parenteral support (intravenous fluid, parenteral nutrition, or parenteral nutrition with intravenous fluid) to compensate for severe malabsorption. The loss of mucosal absorptive area after extensive intestinal resection is accompanied by an accelerated transit and hypersecretion. Changes in physiology and clinical outcomes differ between patients with SBS with or without the distal ileum and/or colon-in-continuity.
View Article and Find Full Text PDFImplication of sugar, protein and incretins in excessive glucagon secretion in type 2 diabetes after mixed meals.
Clin Nutr
April 2023
Department of Endocrinology, Diabetes and Nutrition, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Berlin, Germany; German Center for Diabetes Research (Deutsches Zentrum Für Diabetesforschung e.V.), Ingolstädter Landstraße 1, 85764, Neuherberg, Germany. Electronic address:
Aims: Amino acids powerfully release glucagon but their contribution to postprandial hyperglucagonemia in type 2 diabetes remains unclear. Exogenously applied GIP stimulates, while GLP-1 inhibits, glucagon secretion in humans. However, their role in mixed meals is unclear, which we therefore characterized.
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