INS and Hyperglycemia: Of note, HbA1c levels were similar at both 24 and 48 weeks among those on pasireotide monotherapy and pasireotide plus pegvisomant combination therapy [87], indicating that improved glycemia seen with pegvisomant likely due to increased insulin sensitivity [81] does not ameliorate suppression of insulin secretion driving pasireotide-induced hyperglycemia [67].