Department of Endocrinology and Metabolism, Clalit Medical Services, Haifa and Western Galilee District, Israel.
Trends Endocrinol Metab. 2019 Feb;30(2):77-79. doi: 10.1016/j.tem.2018.11.007. Epub 2018 Dec 23.
Acromegaly per se predisposes to diabetes. Somatostatin analogs (SSAs) have an overall neutral effect on glycemic control. However, a marked increase in hyperglycemia was observed recently since the introduction of pasireotide long-acting release (PAS-LAR). Sodium glucose cotransporter inhibitors (SGLT2is) have proven their efficacy, cardiovascular safety, and superiority in the management of type 2 diabetes mellitus (T2DM). However, this class is rarely recommended for patients with diabetes and acromegaly. A decreased circulating insulin level is considered unique for this class and might have a beneficial role in the growth hormone-insulin-like growth factor-I (GH-IGF-I) axis. Therefore, SGLT2is should be considered in the management of diabetes in patients with acromegaly. This article highlights the role of this novel class for the management of diabetes in patients with acromegaly.
肢端肥大症本身易导致糖尿病。生长抑素类似物（SSAs）对血糖控制总体上呈中性影响。然而，自从长效帕瑞肽（PAS-LAR）问世以来，最近观察到高血糖显著增加。钠-葡萄糖共转运蛋白抑制剂（SGLT2is）已在 2 型糖尿病（T2DM）的管理中证明了其疗效、心血管安全性和优越性。然而，对于患有糖尿病和肢端肥大症的患者，很少推荐使用此类药物。认为该类药物循环胰岛素水平降低是其独特的特点，并且可能在生长激素-胰岛素样生长因子-I（GH-IGF-I）轴中发挥有益作用。因此，SGLT2is 应考虑用于肢端肥大症患者的糖尿病管理。本文强调了该新型药物类别在肢端肥大症患者糖尿病管理中的作用。
