Characteristics and treatment responsiveness of patients with acromegaly and a paradoxical GH increase to oral glucose load

2021 ◽  
Author(s):  
Virginie Atquet ◽  
Orsalia Alexopoulou ◽  
Dominique Maiter
Keyword(s):  
Retrospective Study ◽  
Glucose Tolerance Test ◽  
Somatostatin Analogs ◽  
Tolerance Test ◽  
Oral Glucose ◽  
Oral Glucose Tolerance ◽  
Oral Glucose Load ◽  
Glucose Load ◽  
Pituitary Tumours ◽  
Treatment Responsiveness

Objectives: We aimed to investigate the clinical, biochemical, histological and radiological characteristics as well as the response to somatostatin analogs (SSA) in a large cohort of acromegaly patients with a paradoxical GH response (PR) to oral glucose tolerance test (OGTT). Design: retrospective study. Methods: Of 110 patients with acromegaly included in our study, 30 (PR+; 27%) had a paradoxical GH increase of more than 25% relative to basal GH levels during OGTT. Results : At diagnosis, PR+ patients were older than PR- patients (52 ± 16 vs 44 ± 14 years, p<0.05) and had smaller pituitary tumours (40% microadenomas vs 19%, p<0.05), which were less often invasive (17 vs 35%, p<0.05), overall more secreting (IGF-1/tumoural surface: 2.35 ULN/cm² [0.28-9.06] vs 1.08 [0.17- 7.87], p=0.011), and more often hypointense on T2-weighted MRI (92 vs 48%, p=0.001). While the rate of remission after surgery was similar in the two groups (69%), a better response to SSA treatment was observed in PR+ patients, either before (IGF-1 reduction of > 50% after 3-6 months in 77 vs 49%, p=0.023) or after surgery (normalization of IGF-1 in 100 vs 44%, p=0.011). Conclusions: Our study demonstrates that in acromegaly, a paradoxical GH increase during OGTT is associated with particular features of somatotroph adenomas and with a better prognosis in terms of response to somatostatin analogs.

Evidence that the oral glucose-tolerance test does not provide a uniform stimulus to pancreatic islets in pregnancy.

1989 ◽  
Vol 35 (7) ◽  
pp. 1482-1485 ◽  
Author(s):  
E A de Leacy ◽  
D M Cowley
Keyword(s):  
Glucose Tolerance ◽  
Oral Glucose Tolerance Test ◽  
Pancreatic Islets ◽  
Glucose Tolerance Test ◽  
Insulin Response ◽  
Tolerance Test ◽  
Glucose Absorption ◽  
Oral Glucose ◽  
Oral Glucose Tolerance ◽  
Glucose Load

Abstract Fifty consecutive pregnant patients referred for a glucose-tolerance test were classified on the basis of increasing (n = 20) or decreasing (n = 28) hematocrit after an oral 75-g glucose load. (The hematocrit did not change in the other two patients.) Patients with increasing hematocrit, a response previously seen in patients with the dumping syndrome, showed significantly flatter increases in glucose concentrations in plasma after the load. The mean decrease in the concentration of phosphate in plasma, measured as an index of glucose uptake by cells, was significantly less (P less than 0.05) 2 h after the load in the group with flatter glucose responses, suggesting that the flat response is ascribable to poor glucose absorption rather than to an exaggerated insulin response. These results indicate that the oral glucose-tolerance test stresses the pancreatic islets differently in different pregnant subjects, owing to individual variations in the gastrointestinal handling of the glucose load. Consequently, patients may give a "normal" result who might otherwise become hyperglycemic after normal meals. We suggest that alternative screening procedures be investigated to assess pregnant patients postprandially.

scholarly journals Glycemic Effects of Honey Compared to Glucose Using Standard OGTT

2017 ◽  
Vol 7 (2) ◽  
pp. 95-100
Author(s):  
Lubna Naznin ◽  
Muhammad Rabiul Hossain ◽  
Debashish Saha ◽  
Sarmin Sultana ◽  
Mreenal Kanti Sarkar
Keyword(s):  
Glucose Tolerance ◽  
Glucose Level ◽  
Plasma Glucose ◽  
Plasma Glucose Level ◽  
Glucose Tolerance Test ◽  
Tolerance Test ◽  
Oral Glucose ◽  
Oral Glucose Tolerance ◽  
Glucose Load ◽  
Load State

Background: Honey, though rich in fructose and glucose, had been shown to have plasma glucose lowering effect. It may be as a result of insulin sensitization, enhanced insulin secretion and anti-oxidant activity.Objective: This study was designed to assess the glycemic effects of honey comparing to glucose.Materials and Methods: The study was carried out at Armed Forces Institute of Pathology (AFIP), Dhaka cantonment from September, 2015 to October, 2015 on 35 individuals who reported to AFIP for ‘Oral Glucose Tolerance Test (OGTT)’. They were categorized to three groups based on OGTT ? Normal, Impaired glucose homeostasis (IGT or IFG), and Diabetes mellitus. On the subsequent day they were subjected to 52 mL honey load (equivalent to 75 gm by weight) to assess plasma glucose level after 1 hour and 2 hours posthoney load state. Student t-test was done to compare between means of plasma glucose level 1 hour after 75 gm glucose load and 1 hour after 75 gm honey load and also between means of plasma glucose level 2 hours after 75 gm glucose load and 2 hours after 75 gm honey load in the same individuals.Results: In all the three groups mean plasma glucose level in post-honey load state was found declined compared to post-glucose load state in both 1 hour and 2 hours specimens of HTT (Honey Tolerance Test) versus OGTT (Oral Glucose Tolerance Test) and this reduction was statistically significant (p<0.05).Conclusion: The study findings provide evidence that honey consumption causes less change in plasma glucose level than the equivalent quantity of oral glucose load regardless of status of glucose homeostasis. Further well designed researches are needed to determine the long term effects and beneficial quantity of honey, particularly in relation to diabetes mellitus.J Enam Med Col 2017; 7(2): 95-100

Short-Term Effect of a 75 g Oral Glucose Load on Glycohaemoglobin Levels

1987 ◽  
Vol 24 (1) ◽  
pp. 53-57 ◽  
Author(s):  
Richard D Forrest ◽  
Caroline A Jackson ◽  
Barry J Gould ◽  
Marianne Casburn-Budd ◽  
Julie E Taylor ◽  
...  
Keyword(s):  
Schiff Base ◽  
Glucose Tolerance ◽  
Glucose Tolerance Test ◽  
Tolerance Test ◽  
Assay Method ◽  
Oral Glucose ◽  
Oral Glucose Load ◽  
Glucose Load ◽  
Agar Gel ◽  
Electrophoretic Method

Two hundred and twenty-three subjects out of a total of 347 with various degrees of glucose tolerance were recalled after a screening survey for diabetes. They were a randomly selected sample of people over the age of 40 and they underwent a formal 75 g glucose tolerance test in order to assess the effect of a glucose load on glycohaemoglobin levels measured by four different assay methods. Oral glucose loading was found to affect glycohaemoglobin levels only when these were measured by an agar-gel electrophoretic method that did not remove the labile aldimine-linked Schiff base fraction. The increase in glycohaemoglobin during the glucose tolerance test as estimated by this method was proportional to the 2 h blood glucose level. Glycohaemoglobin levels measured by agar-gel electrophoresis with elimination of the Schiff base, by affinity chromatography and by iso-electric focussing, were not affected by a 75 g oral glucose load. We conclude that blood samples for glycohaemoglobin assay may be collected at any time of the day, without regard to the subject's previous food intake, provided an assay method is used that removed the aldimine-linked labile fraction.

scholarly journals Effects of Somatostatin Analogs on Glucose Homeostasis: A Metaanalysis of Acromegaly Studies

2009 ◽  
Vol 94 (5) ◽  
pp. 1500-1508 ◽  
Author(s):  
Gherardo Mazziotti ◽  
Irene Floriani ◽  
Stefania Bonadonna ◽  
Valter Torri ◽  
Philippe Chanson ◽  
...  
Keyword(s):  
Plasma Glucose ◽  
Effect Size ◽  
Glucose Tolerance Test ◽  
Somatostatin Analogs ◽  
Tolerance Test ◽  
Oral Glucose ◽  
Oral Glucose Tolerance ◽  
Eligibility Criteria ◽  
Fasting Plasma ◽  
Fasting Plasma Insulin

Abstract Background: Somatostatin analogs (SSA) may influence glucose metabolism, but the clinical relevance of this effect is uncertain because trials performed so far are limited in terms of number of patients and heterogeneity for length and type of follow-up. Purpose: The purpose of the study was to assess, via the metaanalysis of acromegaly studies, the clinical impact of SSA on glucose metabolism. The outcomes analyzed were fasting plasma glucose, fasting plasma insulin, hemoglobin A(1c), and plasma glucose concentrations during oral glucose tolerance test. Study Selection: Eligibility criteria were: 1) duration of SSA treatment of at least 3 wk; 2) available numerical data for at least one of the four biochemical outcomes investigated; 3) measurement of the outcomes before and after SSA treatment; and 4) no selection of acromegalic patients for their responsivity to SSA. After revision, only 31 studies fulfilled eligibility criteria and were therefore selected for data extraction and analysis. Data Synthesis: SSA treatment was found to induce statistically significant decrease in fasting plasma insulin [effect size −0.45, 95% confidence interval (CI) from −0.58 to −0.32, P &lt; 0.001], without any significant change of fasting plasma glucose (effect size +0.04, 95% CI from −0.07 to +0.15, P = 0.52) and hemoglobin A(1c) (effect size +0.11, 95% CI from −0.02 to +0.23, P = 0.09). Serum glucose values during the oral glucose tolerance test were shown to significantly change during SSA treatment (effect size +0.31, 95% CI from +0.17 to +0.45, P &lt; 0.001), although with high inconsistency among trials. Conclusions: Our data suggest that modifications of glucose homeostasis induced by SSA may have an overall minor clinical impact in acromegaly.

Effect of Advancing Pregnancy on the Glucose Tolerance Test and on the 50-g Oral Glucose Load Screening Test for Gestational Diabetes

1986 ◽  
Vol 68 (3) ◽  
pp. 362-365 ◽  
Author(s):  
FRED BENJAMIN ◽  
STEPHEN J. WILSON ◽  
STANLEY DEUTSCH ◽  
VICKI L. SELTZER ◽  
KATHLEEN DROESCH ◽  
...  
Keyword(s):  
Gestational Diabetes ◽  
Glucose Tolerance ◽  
Screening Test ◽  
Glucose Tolerance Test ◽  
Tolerance Test ◽  
Oral Glucose ◽  
Oral Glucose Load ◽  
Glucose Load
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