A háziorvos szerepe az acromegaliás betegek gondozásában, fókuszban a szénhidrát-anyagcsere zavara.

Acromegaly is a rare, but clinically important disease, caused by growth hormone and insulin-like growth factor 1 overproduction. Among the different symptoms and complications, diabetes mellitus is a substantial one. Through different mechanisms, growth hormone affects glucose metabolism and causes insulin resistance. In this paper, we present the medical history of an acromegalic patient, focusing on glucose metabolism abnormalities. We review the effects of different therapeutic modalities used in the treatment of acromegaly on glucose homeostasis. The overproduction of the contra-insulin growth hormone deteriorates glucose metabolism. Therefore, lowering pathologically high growth hormone level by surgical, medical or radiotherapy improves glucose metabolism. On the other hand, first generation somatostatin receptor ligands might worsen glucose homeostasis in some cases, while the second generation somatostatin receptor ligand pasireotide causes hyperglycemia in the majority of patients. The treatment of an acromegalic patient requires complex, interdisciplinary teamwork (endocrinologist, neurosurgeon, radiotherapist and other specialists), led by endocrinologists. General practitioners play an important role in the treatment of acromegalic patients, especially in monitoring the complications of the disease, like glucose metabolism abnormalities. Therefore, they must be familiar with the different therapeutic options and their potential side effects.