Diabetic Ketoacidosis in a Patient with Acromegaly.
- Author:
Eun Hee KOH
1
;
Min Kyung KIM
;
Jin Tae PARK
;
Il Seong NAM-GOONG
;
Joong Yeol PARK
;
Ki Up LEE
;
Min Seon KIM
Author Information
1. Division of Endocrinology and Metabolism, Department of Internal Medicine, University of Ulsan College of Medicine, Seoul, Korea.
- Publication Type:Case Report
- Keywords:
Acromegaly;
Diabetic ketoacidosis;
Growth hormone;
Insulin resistance
- MeSH:
Acromegaly*;
Adult;
Diabetes Mellitus;
Diabetic Ketoacidosis*;
Female;
Glucose;
Growth Hormone;
Humans;
Hyperglycemia;
Insulin;
Insulin Resistance;
Insulin-Like Growth Factor I;
Ketosis;
Metabolism;
Plasma;
Somatostatin
- From:Journal of Korean Society of Endocrinology
2004;19(4):393-398
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
Acromegaly is a chronic, debilitating condition caused by excessive secretion of growth hormone (GH). Impaired glucose tolerance is present in about 20-40% of acromegaly, with diabetes mellitus developing in about 10~15% of patients, but diabetic ketoacidosis is a rare association. Herein is reported a case of diabetic ketoacidosis in a 33 year-old female, with a 4 year history of typical acromegaly features. She presented with severe hyperglycemia and ketoacidosis, but with no other cause for this metabolic derangement. She had elevated plasma GH (50 ng/mL) and IGF-1 (1533 ng/mL) levels, and a pituitary macroadenoma. About 200 units of insulin per day were required for her glycemic control. However, the serum IGF-1 level and daily insulin requirement were significantly tapered after a transsphenoidal adenomectomy and long acting somatostatin analogue treatment. There was a good correlation with the daily insulin requirement and plasma IGF-1 level. This case demonstrates that severe GH excess can cause diabetic ketoacidosis, and that its successful treatment improves glucose metabolism.
