Prolactinomas usually lead to infertility and medical treatment restores fertility. Prolactinoma size might increase during pregnancy (2.1% for microprolactinomas and 21% for macroprolactinomas). In this review article, multiple aspects of prolactinomas care during and before pregnancy were discussed. Dopamine agonists are the treatment of choice, if indicated during pregnancy (cabergoline and bromocriptine, while quinagolide is not recommended). It is recommended to stop dopamine agonists in patients with microprolactinoma during pregnancy and follow the patients for mass effect symptoms and visual disturbances every trimester. Dopamine agonists could be stopped as well in patient with intra-seller macroprolactinomas with more frequent clinical follow ups during pregnancy. Magnetic resonance imaging (MRI) without contrast is indicated for patients suspected to have tumor enlargement. Dopamine agonists (cabergoline or bromocriptine) are the treatment of choice for invasive/metastatic macroprolactinomas during pregnancy, and neurosurgery is rarely indicated.
Glucagon-like peptide-1 (GLP-1) overpowers glucagon secretion, endorses satiety, postpones gastric draining, and arouses peripheral glucose consumption. This systematic review was carried out including PubMed, Google Scholar, and EBSCO that examined randomized controlled trials, observational, and experimental studies that had studied the role of GLP-1 (liraglutide) in controlling juvenile diabetes. The study included 7 studies and concluded that the introduction of liraglutide to insulin treatment juvenile diabetic patients results in a considerable and fast decrease in glycemic excursions and a consequent reduction in insulin dose. Body weight decreases substantially as reported in many studies.
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