Effect of Sodium-Glucose Co-Transporter 2 Inhibitors on Insulin-Like Growth Factor 1 Level in Diabetic Acromegaly Patients

Background: Acromegaly is a rare endocrine disorder marked by elevated levels of growth hormone (GH) and insulin-like growth factor 1 (IGF-1), which frequently result in insulin resistance and diabetes mellitus (DM). Sodium-glucose co-transporter 2 inhibitors (SGLT2is) have demonstrated potential in managing DM, but their impact on IGF-1 levels in patients with acromegaly and DM remains not fully understood.

Methods: This study aimed to investigate the effects of SGLT2is on IGF-1 levels in patients with acromegaly and DM.

Methods: Fourteen adult patients with acromegaly and DM treated with SGLT2is were included in this single-center, retrospective clinical trial. Plasma glucose, HbA1c, creatinine, GH, and IGF-1 levels were measured before and at 6 and 12 months after initiating SGLT2i treatment. Statistical analyses were performed to assess changes in these parameters over time.

Results: No statistically significant differences were observed in plasma glucose, HbA1c, creatinine, GH, and IGF-1 levels in the overall patient group at 6 and 12 months of follow-up. However, a significant decrease in IGF-1 levels was noted at both time points in patients with IGF-1 levels <1.5 times the upper limit of normal. No correlations were found between changes in metabolic parameters and IGF-I levels.

Conclusion: Our findings suggest that SGLT2is may have a role in modulating IGF-1 levels in a subset of patients with acromegaly, particularly those with relatively higher IGF-1 levels. This study represents the first investigation into the effects of SGLT2is on IGF-1 levels in patients with acromegaly and DM, providing a foundation for future research in this area. Further studies are needed to confirm these results and elucidate the underlying mechanisms.

Cite this article as: Cavnar Helvaci B, Hepsen S, Kızılgul M, Boz O, Durantas H, Cakal E. Effect of sodium-glucose co-transporter 2 inhibitors on insulin-like growth factor 1 level in diabetic acromegaly patients. Endocrinol Res Pract. Published online March 3, 2025. doi 10.5152/erp.2025.24541