From the Guidelines
Lanreotide is likely the cause of your worsened blood sugar control and morning hyperglycemia due to its effects on insulin secretion and glucose regulation, as evidenced by its mechanism of action as a somatostatin analog 1. As a somatostatin analog, lanreotide suppresses the release of various peptide hormones, including insulin, which naturally raises blood glucose levels 1. This effect is particularly noticeable in the morning due to the dawn phenomenon, when your body naturally produces more glucose-raising hormones. Some key points to consider:
- Lanreotide can reduce glucagon-like peptide-1 (GLP-1) levels, further impairing insulin production 1.
- Since you have a pancreatic neuroendocrine tumor with liver metastases, your glucose metabolism is already compromised, making you more susceptible to these effects.
- The side effects of somatostatin analogues, such as lanreotide, include hypo- and hyperglycaemia, as reported in the guidelines for the management of gastroenteropancreatic neuroendocrine tumours 1. To manage this side effect, you should work with your endocrinologist to:
- Adjust your diabetes medications, possibly adding or increasing insulin therapy, particularly basal insulin to address morning hyperglycemia.
- Implement more frequent blood glucose monitoring, especially before breakfast. While lanreotide is necessary for treating your PNET, its impact on blood sugar can be managed with appropriate medication adjustments and careful monitoring, as recommended in the guidelines for the management of gastroenteropancreatic neuroendocrine tumours 1.
From the FDA Drug Label
Pharmacological studies in animals and humans show that lanreotide, like somatostatin and other somatostatin analogs, inhibits the secretion of insulin and glucagon. Hence, patients treated with Lanreotide Injection may experience hypoglycemia or hyperglycemia Blood glucose levels should be monitored when lanreotide treatment is initiated, or when the dose is altered, and antidiabetic treatment should be adjusted accordingly
The lanreotide treatment may be causing your blood sugar control to worsen, particularly with morning hyperglycemia, due to its effect on insulin and glucagon secretion. It is essential to monitor your blood glucose levels and adjust your antidiabetic treatment as needed.
- Key points:
From the Research
Blood Sugar Control and Lanreotide
- The use of lanreotide for treating metastatic pancreatic neuroendocrine tumors (PNET) can have an impact on blood sugar control, particularly in the morning 3.
- A study on lanreotide autogel 120 mg in treatment-naïve patients with acromegaly found that glycaemic parameters such as glycated haemoglobin (HbA1c) and fasting plasma glucose (FPG) levels were not significantly changed in most patients, but some individuals experienced deterioration in glucose control 3.
- The effect of lanreotide on blood sugar control may be related to its mechanism of action as a somatostatin analogue, which can influence glucose metabolism 3.
Morning Hyperglycemia
- Morning hyperglycemia, or high blood sugar levels in the morning, can be a challenge for individuals with diabetes or those taking certain medications, including lanreotide 3.
- The exact mechanism of lanreotide-induced morning hyperglycemia is not fully understood, but it may be related to the drug's effects on glucose and lipid metabolism 3.
- Studies on other medications, such as GLP-1 receptor agonists and SGLT2 inhibitors, have shown that these drugs can have beneficial effects on glucose control, including reducing morning hyperglycemia 4, 5, 6.
Management of Blood Sugar Control
- Managing blood sugar control while taking lanreotide may require adjustments to diet, exercise, or other medications 3.
- Monitoring blood sugar levels regularly, particularly in the morning, can help identify any changes or trends in glucose control 3.
- Healthcare providers may need to consider alternative treatments or adjustments to the lanreotide regimen to minimize its impact on blood sugar control 7.