Disappearance of Diabetes During Estrogen Therapy in Acromegaly

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THE development of diabetes in acromegaly is a rather common occurrence. Coggeshall and Root,1 in reviewing 153 cases of acromegaly, including the 100 formerly reported by Davidoff and Cushing,2 found glycosuria present in 36 per cent and diabetes in 17 per cent.

Barnes et al,3 Nelson and Overholser,4 and more recently Rodriguez,5 have reported the favorable effect of estrogen administration in experimental pancreatic diabetes in dogs, monkeys, and rats as well as in animals made diabetic by crude anterior pituitary extracts. They postulated an estrogen suppression of the pituitary activity concerned with carbohydrate metabolism.

There is some evidence to suggest that estrogens are capable of inhibiting pituitary growth hormone. Thus Zondek,6 in 1936, produced inhibition of sexual development and dwarfism in the rat and chick by means of estrogenic hormone administration, inhibition which was overcome after administration of Evans’ growth hormone. Beneficial clinical results have been reported after the use of estrogens in the treatment of acromegalic patients, by Kirklin and Wilder,7 Schrire and Sharpey-Schafer,8 Goldberg and Lisser,9 Stephens,10 Reifenstein et al11 and Kinsell et al.12 The doses used varied from 1,000 I. U. (as theelin) to 10 mg. per day (estradiol benzoate) parenterally, or up to 5.0 mg. (natural conjugated estrogens) orally. Beneficial results were judged by amelioration in the clinical condition7–12 as well as a drop in the serum phosphorus and growth hormone levels.12 These results were variously interpreted as due to inhibition of pituitary growth hormone activity7,9–12 or to suppression of an abnormality of metabolism. . .



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