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Abstract
This study aims to describe a case of acromegaly in a young patient with poorly controlled diabetes mellitus and suggest guidelines to distinguish acromegaly and high growth hormone (GH) levels. The authors present a detailed case report, including clinical findings and serial laboratory results in a patient with type 1 diabetes and a GH-secreting pituitary tumor. A 28-year-old woman underwent assessment for secondary amenorrhea and worsening glycemic control. A low estradiol level and an inappropriately low level of follicle-stimulating hormone prompted magnetic resonance imaging of the head, which demonstrated a pituitary adenoma. Subsequent endocrine investigation revealed a high insulin-like growth factor I level. The concentration of insulin-like growth factor-binding protein-3 was also elevated. GH levels measured during episodes of spontaneous hyperglycemia were in the range of 3 ng/mL to 5 ng/mL and failed to suppress to below 2 ng/mL after a bromocriptine suppression test. The patient underwent transsphenoidal resection of a pituitary tumor. Postoperatively, glycemic control improved, with decreased fluctuations of hypoglycemia and hyperglycemia.