Management of type 2 diabetes mellitus associated with pituitary gigantism

被引:15
作者
Ali, Omar [4 ]
Banerjee, Swati [1 ]
Kelly, Daniel F. [2 ]
Lee, Phillip D. K. [3 ,4 ]
机构
[1] Childrens Hosp Cent Calif, Dept Endocrinol, Madera, CA 93636 USA
[2] John Wayne Canc Inst, Santa Monica, CA 90404 USA
[3] EMD Serono Inc, Endocrinol & Reproduct Hlth, Clin Dev, Rockland, MA 02370 USA
[4] Univ Calif Los Angeles, David Geffen Sch Med, Dept Pediat, Los Angeles, CA 90095 USA
关键词
pituitary gigantism; growth hormone; diabetes mellitus; diabetic ketoacidosis; metformin;
D O I
10.1007/s11102-007-0060-8
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
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.
引用
收藏
页码:359 / 364
页数:6
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