Pasireotide‐induced hyperglycemia in a patient with Cushing's disease: Potential use of sodium‐glucose cotransporter 2 inhibitor and glucagon‐like peptide‐1 receptor agonist for treatment

Shikata, Masato; Ashida, Kenji; Goto, Yuka; Nagayama, Ayako; Iwata, Shimpei; Yano, Mamiko; Hasuzawa, Nao; Hara, Kimihiko; Mawatari, Ken‐ichi; Sakata, Kiyohiko; Tsuruta, Munehisa; Wada, Nobuhiko; Nomura, Masatoshi

doi:10.1002/ccr3.3230

Cited by 5 publications

(2 citation statements)

References 21 publications

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“…In summary, in patients with pasireotide-related hyperglycaemia we suggest starting GLP1-RA and metformin as a first-line approach and avoiding DPP4-i, in accordance with the findings of the previous studies ( 120 , 121 ) and to the mild anti-hyperglycaemic effects of DPP4-i ( Figure 3 ).…”

Section: Cushing’s Syndromesupporting

confidence: 90%

“…In patients with pasireotide-related hyperglycaemia a significant decrease in HbA1c and fasting plasma glycaemia was obtained using GLP1-RA compared to other antidiabetic drugs such as metformin and DPP4-i ( 120 ). Further, a case of a man with pasireotide-induced hyperglycaemia successfully treated with a combination of GLP1-RA, insulin and empaglifozin was also reported ( 121 ). The most robust findings are those reported by Samson et al., who showed the superiority of the combination of sitagliptin and liraglutide in achieving glucose control ( 122 ).…”

Section: Cushing’s Syndromementioning

confidence: 99%

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Practical therapeutic approach in the management of diabetes mellitus secondary to Cushing’s syndrome, acromegaly and neuroendocrine tumours

Guarnotta,

Emanuele,

Salzillo

et al. 2023

Front. Endocrinol.

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Cushing’s syndrome, acromegaly and neuroendocrine disorders are characterized by an excess of counterregulatory hormones, able to induce insulin resistance and glucose metabolism disorders at variable degrees and requiring immediate treatment, until patients are ready to undergo surgery. This review focuses on the management of diabetes mellitus in endocrine disorders related to an excess of counterregulatory hormones. Currently, the landscape of approved agents for treatment of diabetes is dynamic and is mainly patient-centred and not glycaemia-centred. In addition, personalized medicine is more and more required to provide a precise approach to the patient’s disease. For this reason, we aimed to define a practical therapeutic algorithm for management of diabetes mellitus in patients with glucagonoma, pheochromocytoma, Cushing’s syndrome and acromegaly, based on our practical experience and on the physiopathology of the specific endocrine disease taken into account. This document is addressed to all specialists who approach patients with diabetes mellitus secondary to endocrine disorders characterized by an excess of counterregulatory hormones, in order to take better care of these patients. Care and control of diabetes mellitus should be one of the primary goals in patients with an excess of counterregulatory hormones requiring immediate and aggressive treatment.

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Section: Cushing’s Syndromesupporting

confidence: 90%

Section: Cushing’s Syndromementioning

confidence: 99%

Practical therapeutic approach in the management of diabetes mellitus secondary to Cushing’s syndrome, acromegaly and neuroendocrine tumours

Guarnotta,

Emanuele,

Salzillo

et al. 2023

Front. Endocrinol.

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CD26-antigen-inhibitors/metformin/pasireotide

2021

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Strategie terapeutiche nella gestione del diabete mellito secondario a endocrinopatie

Emanuele,

Bonsangue,

Salzillo

et al. 2024

L'Endocrinologo

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SommarioL’acromegalia, la sindrome di Cushing e alcuni tumori neuroendocrini sono caratterizzati da un eccesso di ormoni controregolatori in circolo. Ciò può favorire l’insorgenza di alterazioni del metabolismo del glucosio di varia entità, fino al diabete mellito conclamato. Sebbene il trattamento del diabete secondario in queste endocrinopatie sia conforme alle più recenti evidenze scientifiche e linee guida sulla gestione terapeutica del diabete mellito, ci sono alcuni accorgimenti di cui tenere conto. Lo scopo di questa Rassegna è quello di fornire strumenti di riflessione e conoscenza per migliorare l’approccio terapeutico e diagnostico a questi pazienti che presentano differenze intrinseche alla fisiopatologia di ciascuna condizione affrontata. Un altro aspetto da non sottovalutare riguarda l’insorgenza di diabete mellito (ovvero il peggioramento del compenso glicometabolico nei pazienti diabetici) correlato ad alcuni farmaci utilizzati per trattare la malattia primaria, come il pasireotide. La necessità di trattare il diabete mellito secondario in queste patologie endocrine è finalizzata non solo a ripristinare l’euglicemia ma anche a prevenire e rallentare le complicanze cardio-renali che si associano sia al diabete che alla malattia primaria. A questo proposito si suggerisce, quindi, un algoritmo di trattamento applicabile alle diverse patologie descritte. Il campo delle complicanze metaboliche legate alle endocrinopatie e dei farmaci utilizzati nel trattamento di queste patologie richiede studi più approfonditi e rappresenta un’area di crescente importanza nel campo dell’endocrinologia.

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Pasireotide‐induced hyperglycemia in a patient with Cushing's disease: Potential use of sodium‐glucose cotransporter 2 inhibitor and glucagon‐like peptide‐1 receptor agonist for treatment

Abstract: This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

Cited by 5 publications

References 21 publications

Practical therapeutic approach in the management of diabetes mellitus secondary to Cushing’s syndrome, acromegaly and neuroendocrine tumours

Practical therapeutic approach in the management of diabetes mellitus secondary to Cushing’s syndrome, acromegaly and neuroendocrine tumours

CD26-antigen-inhibitors/metformin/pasireotide

Strategie terapeutiche nella gestione del diabete mellito secondario a endocrinopatie

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