Strategie terapeutiche nella gestione del diabete mellito secondario a endocrinopatie

Acromegaly, Cushing’s syndrome and some neuroendocrine tumours are characterised by an excess of circulating counterregulatory hormones. This can favour the onset of glucose metabolism alterations of varying degrees, up to full-blown diabetes mellitus. Although the treatment of secondary diabetes in these endocrinopathies complies with the most recent scientific evidence and guidelines on the therapeutic management of diabetes mellitus, there are certain precautions to be taken into account. The aim of this article is to provide tools for reflection and knowledge to improve the therapeutic and diagnostic approach to these patients who present differences intrinsic to the pathophysiology of each condition addressed. Another aspect not to be underestimated concerns the onset of diabetes mellitus (or the worsening of glycometabolic compensation in diabetic patients) related to certain drugs used to treat the primary disease, such as pasireotide. The need to treat secondary diabetes mellitus in these endocrine disorders is aimed not only at restoring euglycaemia but also at preventing and slowing down the cardio-renal complications that are associated with both diabetes and the primary disease. In this regard, a treatment algorithm is therefore suggested, which can be applied to the various conditions described. The field of metabolic complications linked to endocrinopathies and the drugs used in the treatment of these conditions requires more in-depth study and represents an area of increasing importance in the field of endocrinology.