Acromegaly leads to development of secondary diabetes mellitus in 25-55.9% of cases.[1] The hyper secretion of growth hormone (GH) exposes peripheral organs such as the retina and kidney to conditions favoring the expression of growth-hormone-dependent growth factors such as insulin growth factor I (IGF-I) which may contribute to the development of diabetic microvascular disease by autocrine and/or paracrine effects[1] However reported incidence of diabetic retinopathy in acromegaly is low[2] and severe retinopathy is uncommon.[3]. The gene discussed is IGF1; the disease is acromegaly.