TOPLINE

Patients with acromegaly-associated diabetes had a higher risk for cardiovascular morbidity than those with type 2 diabetes (T2D), which was mainly driven by venous thromboembolism, pulmonary embolism, and arrhythmia.

METHODOLOGY

• Researchers in Sweden conducted a nationwide, observational, matched cohort study by linking multiple Swedish health and administrative registries to compare mortality, morbidity, and treatment patterns between patients with acromegaly-associated diabetes and those with T2D.
• Patients were considered to have acromegaly-associated diabetes if they had both a documented diagnosis of acromegaly and evidence of diabetes — either a formal diagnosis in the national diabetes registry or a filled prescription for a glucose-lowering medication.
• A total of 348 patients with acromegaly-associated diabetes (mean age, 60.3 years; 51% women) were included and matched (10:1) with 3480 control patients with T2D (mean age, 59.5 years; 51% women). The mean follow-up duration was around 9 years for both the cohorts.
• Primary outcomes were risks for overall and cardiovascular mortality in patients with acromegaly-associated diabetes vs control individuals with T2D, and secondary outcomes were cardiovascular morbidity and treatment patterns.
• Data on morbidity and mortality were obtained from death and patient registries.

TAKEAWAY

• Cardiovascular disease was more prevalent in patients with acromegaly-associated diabetes than in those with T2D (61% vs 43%), including hypertension (48% vs 29%), heart failure (11% vs 5%), arrhythmia (13% vs 9%), and stroke (8% vs 5%).
• Patients with acromegaly-associated diabetes had a higher risk for cardiovascular morbidity than those with T2D (adjusted hazard ratio [aHR], 1.55; 95% CI, 1.24-1.94), with a time to the first cardiovascular event being shorter in those with acromegaly-associated diabetes.
• Specifically, the risk for venous thromboembolism (aHR, 2.27; 95% CI, 1.29-4.00), pulmonary embolism (aHR, 3.26; 95% CI, 1.94-5.45), and arrhythmia (aHR, 1.48; 95% CI, 1.11-1.98) was higher in those with acromegaly-associated diabetes than in those with T2D. The risk for cardiovascular mortality did not differ between the two groups. 
• Patients with acromegaly-associated diabetes received metformin less frequently than those with T2D (65% vs 76%; P < .001).

IN PRACTICE

"[The study] results underscore the importance of the management of hypertension and modifiable risk factors for stroke and heart failure to mitigate the cardiovascular burden in the ACRO-DM [acromegaly-associated diabetes] population," the authors wrote.

SOURCE

This study was led by Angelo Milioto, Department of Internal Medicine and Clinical Nutrition, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden. It was published online on August 10, 2026, in The Journal of Clinical Endocrinology & Metabolism.

LIMITATIONS

The study was retrospective in nature. Effects of disease control on study outcomes were not assessed due to the lack of data on growth hormone and insulin-like growth factor 1 levels.

DISCLOSURES

This study received financial support from Swedish governmental funding of clinical research, Svenska Sällskapet för Medicinsk Forskning, Åke Wibergs Stiftelse, and other sources. Some authors declared receiving lecture fees, advisory board and steering committee honoraria, or research grants or serving as consultants for various pharmaceutical companies.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.