Diagnosis and management of acromegaly

Table 3: Treatment objectives in the management of acromegaly

1. Relief of salient symptoms
2. Achievement of biochemical targets
   • Normalization of elevated IGF-I levels
   • Reduction of plasma growth-hormone levels to 2 µg/L or less during a 2-h oral glucose tolerance test
   • Reversal of paradoxical growth-hormone responses to TRH or GnRH
3. Eradication of tumour or reduction of tumour size with relief of compressive effects
4. Prevention of long-term complications of excess growth hormone and IGF-I