Related Experiment Videos
Cardivascular Risk Profile in Patients with Diabetes and Acromegaly or Cushing's Disease - Analysis from the DPV
Katharina Warncke1, Sebastian Kummer2, Peter Herbert Kann3
1Department of Pediatrics, Klinikum rechts der Isar, Technische Universität München, Munich, Germany.
Insights
Patients with acromegaly and Cushing's disease experience diabetes at a younger age and have high cardiovascular risks. Despite this, their diabetes is generally well-controlled, with many requiring insulin therapy.
Area of Science:
- Endocrinology
- Metabolic Diseases
- Cardiovascular Health
Background:
- Diabetes is a frequent complication of acromegaly and Cushing disease.
- Limited research exists on cardiovascular risk, metabolic control, and diabetes management in these conditions.
- This study characterizes diabetes in acromegaly and Cushing disease using the DPV registry.
Purpose of the Study:
- To comprehensively characterize diabetes in patients with acromegaly and Cushing disease.
- To compare cardiovascular risk, metabolic control, and diabetes therapy in these patients versus those with type 1 or type 2 diabetes.
- To leverage the DPV registry for analyzing rare forms of diabetes.
Main Methods:
- Utilized data from the longitudinal DPV registry.
- Included patients aged 18 years and older with diabetes and either acromegaly or Cushing disease.
- Compared these patients to individuals with type 1 or type 2 diabetes using SAS 9.4 statistical software.
Main Results:
- Patients with acromegaly or Cushing disease developed diabetes at a younger age (median 50.1 and 45.0 years) compared to type 2 diabetes (59.0 years).
- Hypertension was most prevalent in acromegaly (56.8%), while dyslipidemia was common across all groups.
- HbA1c levels were well-controlled (median 7.0% and 6.5%) in acromegaly and Cushing disease groups, respectively.
Conclusions:
- Acromegaly patients with diabetes face significant cardiovascular disease risks, indicated by high rates of dyslipidemia and hypertension.
- A substantial percentage of patients with diabetes secondary to acromegaly or Cushing disease require insulin therapy.
- The DPV registry facilitates the analysis of sufficient patient numbers for rare diabetes forms.
Background:
Although diabetes is a common complication of acromegaly or Cushing´s disease, there are only few detailed studies with a focus on cardiovascular risk, metabolic control or diabetes therapy. Here, we provide a comprehensive characterization from the longitudinal DPV (Diabetes Patienten Verlaufsdokumentation) registry.
Methods:
Patients from the registry≥18 years of age with diabetes and acromegaly or Cushing´s disease were compared to patients with type 1 diabetes or type 2 diabetes using the statistical software SAS 9.4.
Results:
Patients with diabetes and acromegaly (n=52) or Cushing's disease (n=15) were significantly younger at diabetes onset (median age 50.1 and 45.0 vs. 59.0 years in type 2 diabetes; both p<0.05). Dyslipidemia was common in both diseases (71.0% and 88.9% vs. 71.8% in type 2 diabetes; n.s.), while hypertension was most frequent in acromegaly (56.8% vs. 20.9% in type 1 diabetes, p<0.00001). 36.5% of patients with acromegaly and 46.7% with Cushing´s disease receive insulin, compared to 50.4% with type 2 diabetes. Oral antidiabetic drugs were used in 36.5% of patients with acromegaly and 40% with Cushing´s disease, with a predominance of biguanides and dipeptidyl peptidase-4 inhibitors. HbA1c was well controlled in both groups (median 7.0% and 6.5%; vs. 7.2% in type 2 diabetes).
Conclusion:
Patients with acromegaly are at a high risk for cardiovascular disease, reflected by dyslipidemia and hypertension. A high proportion of patients with diabetes in acromegaly or Cushing´s disease receives insulin. Based on a multicenter register, a sufficient number of patients with rare forms of diabetes can be analyzed.