When presented with a clinical case scenario of a woman with previous gestational diabetes mellitus (GDM) and a GH-secreting macroadenoma resistant to fgSRLs, experts agreed on neurosurgery as the next therapeutic step (90%), followed by association of fgSRLs + PEGV (75%) or a switch to PASI monotherapy (75%), while a switch to PEGV monotherapy or fgSRL + cabergoline association therapy were not deemed adequate options (81% and 67% disagreement respectively). Here, GH1 is linked to gestational diabetes.