Table 2: Glucose metabolism during treatment with drugs used for pituitary dysfunction.

Drug/condition	Effect on glucose metabolism
GH-replacement therapy	Children – subtle insulin resistance, new onset DM rare; Adults – association with impaired glucose tolerance and DM in initial years, prolonged therapy – improvement in metabolic parameters and decreased CVD risk
Octreotide and lanreotide	Postprandial hyperglycaemia and increase in HbA1c in uncontrolled disease; If disease is under control – neutral or mild improvement in glycaemic indices
Pasireotide	New onset DM, uncontrolled hyperglycaemia
Pegvisomant	Improvement in glycaemic status
Bromocriptine	Quick-release formulation approved for treatment of DM
Cabergoline	Anecdotal reports of glycaemic and weight benefit
GnRH analogue	Increased chance of diabetes, more in males on androgen deprivation therapy
Mifepristone	Approved for treatment of hyperglycaemia in Cushing’s syndrome
Mecasermin	Adverse effect of hypoglycaemia, must be taken with food

CVD = cardiovascular disease; DM = diabetes mellitus; GH = growth hormone; GnRH = gonadotropin-releasing hormone; HbA1c = glycated haemoglobin.