What are the goals of treatment for acromegaly?
The goals of treatment in acromegaly include normalization of GH and IGF-1 levels, reduction in tumour size, prevention of tumour recurrence, and alleviation of significant comorbid features, particularly cardiovascular, pulmonary and metastatic derrangements.4,5 There has been considerable debate on the appropriate level of GH to be achieved when treating acromegaly.6 Normalization of GH levels to less than 2 g/L (5 mU/L) within 2 hours after a glucose load has been suggested as the primary objective of therapeutic intervention,4 and there is now compelling evidence that lowering GH levels to this target concentration reverses the mortality associated with acromegaly.7,8 Nevertheless, recently published management guidelines suggest that more stringent control of GH levels to less than 1 g/L (2.5 mU/L) after an oral glucose load may be required.5 A frequently used alternative is to calculate mean GH levels from five measurements in a single day. In this case, the aim is to reduce mean
