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There are no published guidelines regarding the optimal management of pasireotide-induced hyperglycemia in patients with acromegaly 22 , but the most currently recommended treatment is metformin, followed by dipeptidyl peptidase-4 (DPP-4) inhibitors, GLP-1 analogs, and then insulin 22,23,24

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I discuss these interventions in more detail in my first book, Hashimotos: The Root Cause , as well as in my second book, Hashimotos Protocol

Bile salt hydrolases: Gatekeepers of bile acid metabolism and host-microbiome crosstalk in the gastrointestinal tract