Exp Clin Endocrinol Diabetes 2020; 128(02): 104-110
DOI: 10.1055/a-0600-9649
Original Research
© Georg Thieme Verlag KG Stuttgart · New York

Cardivascular Risk Profile in Patients with Diabetes and Acromegaly or Cushing’s Disease – Analysis from the DPV Database

Katharina Warncke
1   Department of Pediatrics, Klinikum rechts der Isar, Technische Universität München, Munich, Germany
,
Sebastian Kummer
2   Department of General Pediatrics, Neonatology and Pediatric Cardiology, University Children's Hospital, Duesseldorf, Germany
,
Peter Herbert Kann
3   Zentrum für Endokrinologie, Diabetologie & Osteologie, Philipps-Universität/Universitätsklinikum Marburg, Marburg, Germany
,
Dominik Bergis
4   Division of Endocrinology & Diabetes, Department of Internal Medicine 1, University Hospital, Goethe University, Frankfurt am Main, Germany
,
Esther Bollow
5   Institute of Epidemiology and Medical Biometry, Central Institute for Biomedical Technology, University of Ulm, Ulm, Germany
6   German Center for Diabetes Research (DZD), München-Neuherberg, Germany
,
Michael Hummel
7   Specialized Diabetes Practice, Rosenheim
,
Flavius Zoicas
8   Division of Endocrinology and Diabetes, Department of Medicine 1, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen, Germany
,
Sebastian Wernert
9   AKH Wien, Universitätscampus, Wien, Austria
,
Reinhard W. Holl
5   Institute of Epidemiology and Medical Biometry, Central Institute for Biomedical Technology, University of Ulm, Ulm, Germany
6   German Center for Diabetes Research (DZD), München-Neuherberg, Germany
› Author Affiliations
Funding: The DPV registry was supported by the European Foundation for the Study of Diabetes (EFSD). Further financial support was provided by the German Diabetes Association (DDG), and by the German Competence Network Diabetes mellitus (diabetes meta-database) funded by the Federal Ministry of Education and Research (FKZ 01GI1106), now integrated into the German Center for Diabetes Research (DZD).
Further Information

Publication History

received 05 February 2018
revised 26 March 2018

accepted 03 April 2018

Publication Date:
17 October 2018 (online)

Abstract

Background Although diabetes is a common complication of acromegaly or Cushing´s disease, there are only few detailed studies with a focus on cardiovascular risk, metabolic control or diabetes therapy. Here, we provide a comprehensive characterization from the longitudinal DPV (Diabetes Patienten Verlaufsdokumentation) registry.

Methods Patients from the registry≥18 years of age with diabetes and acromegaly or Cushing´s disease were compared to patients with type 1 diabetes or type 2 diabetes using the statistical software SAS 9.4.

Results Patients with diabetes and acromegaly (n=52) or Cushing’s disease (n=15) were significantly younger at diabetes onset (median age 50.1 and 45.0 vs. 59.0 years in type 2 diabetes; both p<0.05). Dyslipidemia was common in both diseases (71.0% and 88.9% vs. 71.8% in type 2 diabetes; n.s.), while hypertension was most frequent in acromegaly (56.8% vs. 20.9% in type 1 diabetes, p<0.00001). 36.5% of patients with acromegaly and 46.7% with Cushing´s disease receive insulin, compared to 50.4% with type 2 diabetes. Oral antidiabetic drugs were used in 36.5% of patients with acromegaly and 40% with Cushing´s disease, with a predominance of biguanides and dipeptidyl peptidase-4 inhibitors. HbA1c was well controlled in both groups (median 7.0% and 6.5%; vs. 7.2% in type 2 diabetes).

Conclusion Patients with acromegaly are at a high risk for cardiovascular disease, reflected by dyslipidemia and hypertension. A high proportion of patients with diabetes in acromegaly or Cushing´s disease receives insulin. Based on a multicenter register, a sufficient number of patients with rare forms of diabetes can be analyzed.

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