Answer: D. A and B. Patients who are obese or have a family history of T2DM are particularly vulnerable to these effects and should closely monitor their glucose status during GH therapy. GH replacement therapy is known overall to reduce insulin sensitivity and increase blood glucose and can also cause an increase in A1c. Such changes have been noted at 6 months after treatment initiation and to persist at 2-year follow-up. Results are similar regardless of dose and duration of treatment. In one randomized, double-blind, placebo-controlled trial, diabetes appeared in 4% of subjects and carbohydrate intolerance in 20% after 12 months.
Díez JJ, Sangiao-Alvarellos S, Cordido F. Treatment with growth hormone for adults with growth hormone deficiency: benefits and risks. Int J Mol Sci. 2018;19:893.