ReviewEndocrine2023
Secondary diabetes mellitus in acromegaly.
Review in Endocrine, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
24 citing papers in PubMed, 35 citations in OpenAlex.
- Acromegaly and cardiovascular disease: mechanisms, clinical impact, and evolving management.Endocrine reviews · 2026Review
- Review
- From Subtle Signs to Severe Sequelae-A Century of Symptomatology and Comorbidities in the Diagnosis of GH-Secreting Pituitary Neuroendocrine Tumors: A Systematic Review.Diagnostics (Basel, Switzerland) · 2025Review
- Cancer screening in patients with acromegaly: a plea for a personalized approach and international registries.Reviews in endocrine & metabolic disorders · 2025Review
- Diabetes mellitus secondary to endocrine diseases: a position statement of the working group of the club of the Italian society of endocrinology (SIE)-Nutrition hormones and metabolism.Journal of endocrinological investigation · 2025Review
- Early Predictors of Remission in Acromegaly Patients after Pure Endoscopic Endonasal Transsphenoidal Surgery.Journal of neurological surgery. Part B, Skull base · 2025Article
- Review
- Evaluation of fluid status in patients with acromegaly through bioelectrical impedance vector analysis: a cross-sectional study.Journal of endocrinological investigation · 2025Article
- Insights into GLP-1 and insulin secretion mechanisms in pasireotide-induced hyperglycemia highlight effectiveness of Gs-targeting diabetes treatment.Scientific reports · 2025Article
- Acromegaly and Cardiovascular Disease: Associated Cardiovascular Risk Factors, Cardiovascular Prognosis, and Therapeutic Impact.Journal of clinical medicine · 2025Review
- Differential Impact of Medical Therapies for Acromegaly on Glucose Metabolism.International journal of molecular sciences · 2025Review
- Treatment of acromegaly-induced diabetes: an updated proposal.Pituitary · 2024Review
- Effect of Cabergoline on weight and glucose metabolism in patients with acromegaly.Journal of endocrinological investigation · 2024Article
- The Use of Kidney Biomarkers, Nephrin and KIM-1, for the Detection of Early Glomerular and Tubular Damage in Patients with Acromegaly: A Case-Control Pilot Study.Diseases (Basel, Switzerland) · 2024Article
- Diabetes mellitus in patients with acromegaly: pathophysiology, clinical challenges and management.Nature reviews. Endocrinology · 2024Review
- Review
- Glucose intolerance in acromegaly is driven by low insulin secretion; results from an intravenous glucose tolerance test.Pituitary · 2024Article
- Article
- A review of complex hormone regulation in thyroid cancer: novel insights beyond the hypothalamus-pituitary-thyroid axis.Frontiers in endocrinology · 2024Review
- Management of Diabetes Mellitus in Acromegaly and Cushing's Disease with Focus on Pasireotide Therapy: A Narrative Review.Diabetes, metabolic syndrome and obesity : targets and therapy · 2024Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
8 authors at 4 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Secondary diabetes mellitus (DM) is a common complication of acromegaly, encountered in up to 55% of cases. Vice versa, the prevalence of acromegaly is markedly higher in cohorts of patients with type 2 DM (T2DM). The presence of secondary DM depends primarily on acromegaly status and is associated with increased cardiovascular morbidity, malignancy rate and overall mortality. The principal pathophysiologic mechanism is increased insulin resistance due to excessive lipolysis and altered fat distribution, reflected at the presence of intermuscular fat and attenuated, dysfunctional adipose tissue. Insulin resistance is ascribed to the direct, diabetogenic effects of growth hormone (GH), which prevail over the insulin-sensitizing effects of insulin-like growth factor 1 (IGF-1), probably due to higher glucometabolic potency of GH, IGF-1 resistance, or both. Inversely, GH and IGF-1 act synergistically in increasing insulin secretion. Hyperinsulinemia in portal vein leads to enhanced responsiveness of liver GH receptors and IGF-1 production, pointing towards a mutually amplifying loop between GH-IGF-1 axis and insulin. Secondary DM occurs upon beta cell exhaustion, principally due to gluco-lipo-toxicity. Somatostatin analogues inhibit insulin secretion; especially pasireotide (PASI) impairs glycaemic profile in up to 75% of cases, establishing a separate pathophysiologic entity, PASI-induced DM. In contrast, pegvisomant and dopamine agonizts improve insulin sensitivity. In turn, metformin, pioglitazone and sodium-glucose transporters 2 inhibitors might be disease-modifying by counteracting hyperinsulinemia or acting pleiotropically. Large, prospective cohort studies are needed to validate the above notions and define optimal DM management in acromegaly.
Indexed as
Identifiers
What Socratic holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.