The Library
Managing hyperglycemia in patients with Cushing's disease treated with pasireotide : medical expert recommendations
Tools
Colao, A., De Block, C., Gaztambide, M. S., Kumar, Sudhesh, Seufert, J. and Casanueva, F. F. (2014) Managing hyperglycemia in patients with Cushing's disease treated with pasireotide : medical expert recommendations. Pituitary, 17 (2). pp. 180-186. doi:10.1007/s11102-013-0483-3
Research output not available from this repository.
Request-a-Copy directly from author or use local Library Get it For Me service.
Official URL: https://doi.org/10.1007/s11102-013-0483-3
Abstract
To recommend an approach to monitoring and treating hyperglycemia in pasireotide-treated patients with Cushing's disease, a severe clinical condition caused by a pituitary adenoma hypersecreting adrenocorticotropic hormone. Advisory Board meeting of ten European experts in pituitary disease and diabetes mellitus in Munich, Germany, on February 23, 2012, to obtain expert recommendations. Cushing's disease presents a number of management challenges. Pasireotide, a novel agent for the treatment of Cushing's disease with proven biochemical and clinical efficacy, improves outcomes and expands treatment options. Clinical trials have shown that the pasireotide adverse event profile is similar to that of other somatostatin analogs, except for a higher frequency of hyperglycemia. Mechanistic studies in healthy volunteers suggest that pasireotide-associated hyperglycemia is due to reduced secretion of glucagon-like peptide (GLP)-1, glucose-dependent insulinotropic polypeptide, and insulin; however, it is associated with intact postprandial glucagon secretion. Individual patients' results demonstrate effective hyperglycemia management by following standard guidelines for the treatment of diabetes mellitus with individual adaptation to the specific underlying pathophysiology, i.e., preferential use of GLP-1 based-medications. Patients on pasireotide treatment should be monitored for changes in glucose metabolism and hyperglycemia. Diabetes mellitus should be managed by initiation of medical therapy with metformin and staged treatment intensification with a dipeptidyl peptidase-4 inhibitor, with a switch to a GLP-1 receptor agonist and initiation of insulin, as required, to achieve and maintain glycemic control. Further research into hyperglycemia following pasireotide treatment will help refine the optimal strategy in Cushing's disease.
Item Type: | Journal Article | ||||
---|---|---|---|---|---|
Subjects: | Q Science > QP Physiology R Medicine > RC Internal medicine |
||||
Divisions: | Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School | ||||
Library of Congress Subject Headings (LCSH): | Hyperglycemia -- Treatment, Cushing's syndrome -- Patients | ||||
Journal or Publication Title: | Pituitary | ||||
Publisher: | Springer | ||||
Official Date: | April 2014 | ||||
Dates: |
|
||||
Volume: | 17 | ||||
Number: | 2 | ||||
Page Range: | pp. 180-186 | ||||
DOI: | 10.1007/s11102-013-0483-3 | ||||
Status: | Peer Reviewed | ||||
Publication Status: | Published | ||||
Access rights to Published version: | Open Access (Creative Commons) | ||||
Related URLs: |
Request changes or add full text files to a record
Repository staff actions (login required)
View Item |