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CC BY-NC-ND 4.0 · Journal of Diabetes and Endocrine Practice 2022; 05(03): 092-103
DOI: 10.1055/s-0042-1760392
Review Article

Contemporary Management of Acromegaly: A Practical Approach

Mussa H. Almalki 
1   Obesity, Endocrine and Metabolism Center, King Fahad Medical City, Riyadh, Saudi Arabia
,
Maswood M. Ahmad 
1   Obesity, Endocrine and Metabolism Center, King Fahad Medical City, Riyadh, Saudi Arabia
,
Ali Alqahtani 
1   Obesity, Endocrine and Metabolism Center, King Fahad Medical City, Riyadh, Saudi Arabia
,
Wael M. Almistehi
1   Obesity, Endocrine and Metabolism Center, King Fahad Medical City, Riyadh, Saudi Arabia
,
Aishah Ekhzaimy 
2   Department of Medicine, Endocrinology and Diabetes Unit, College of Medicine and King Saud University Medical City, King Saud University, Riyadh, Saudi Arabia
,
Mohammed J. Asha
3   Division of Neurosurgery, Department of Surgery, Tawam Hospital, United Arab Emirates
,
Khaled M. Aldahmani 
4   Department of Medicine, Tawam Hospital, Al Ain, United Arab Emirates
5   Department of Medicine, UAE University, United Arab Emirates
› Author Affiliations Sponsorship and Funding The study received no sponsorship or funding.
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Abstract

Acromegaly is a rare, chronic disease that is, in more than 95% of cases, caused by a growth hormone (GH)-secreting pituitary adenoma. Overproduction of insulin-like growth factor-1 (IGF-1) due to GH hypersecretion leads to various clinical features characterized by somatic overgrowth, physical changes, multiple comorbidities, and increased mortality. The average age at diagnosis is 40 to 50 years, with no sex predilection. The mean delay in diagnosis is 4.5 to 5 years due to the insidious onset and slow clinical progression of the disease. The diagnosis is confirmed by increased levels of IGF-1 and insuppressible GH measured by an oral glucose tolerance test. Treatment is aimed at normalizing GH/IGF-1 levels and controlling tumor volume. Medical treatment and radiotherapy can be utilized when surgery fails to control GH/IGF-1 hypersecretion. This article aims to review recent updates in acromegaly diagnosis and treatment to raise awareness about acromegaly clinical presentation and management.

Keywords

acromegaly - clinical features - diagnosis - mortality - treatment - surgery - medical therapy - radiotherapy - outcome

Authors' Contributions

The authors were assigned specific sections to draft, which were developed into a single manuscript reviewed and approved by all authors.


Compliance with Ethical Principles

Not applicable.




Publication History

Article published online:
23 January 2023

© 2023. Gulf Association of Endocrinology and Diabetes (GAED). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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