Acromegaly, also known as amyotrophic lateral sclerosis, is genetic in a small number of cases, but the cause of most cases is unclear and is thought to be related to a genetic mutation; diabetes does not usually cause acromegaly. Amyotrophic lateral sclerosis is a chronic, progressive and fatal neurodegenerative disease that primarily involves upper and lower motor neurons and the muscles they innervate. The cause of the disease is often unclear, and the earliest typical symptoms are usually marked weakness or atrophy of the muscles, with other symptoms including difficulty swallowing, spasms, or stiffness of the involved muscles. The development of acromegaly is genetically related and may also be associated with exposure to organic solvents, heavy metal elements, low body mass index, autoimmune abnormalities, metabolic disorders, viral infections, and neuroinflammatory responses, but not diabetes mellitus. Patients with diabetes or acromegaly should be treated under medical supervision.