IGF1 and diabetes mellitus: The case also highlights acromegaly-associated complications like multinodular goiter, diabetes mellitus, macular degeneration, glaucoma, sleep apnea, and the need for transsphenoidal surgery, which successfully achieved tumor debulking and IGF-1 stabilization without further medical therapy of somatostatin receptor ligands (SRLs), cabergoline, or pegvisomant [15,16].