The prevalence of comorbid glucose metabolism abnormalities is much higher in patients with acromegaly than in the general population. It is reported that 19-56% of patients with acromegaly have diabetes mellitus and 16-46% have hypoglycemia. Elevated blood glucose can affect multiple organs, causing cardiac and macrovascular disease, nephropathy, retinopathy, etc. The mortality rate of patients with diabetes mellitus is 2.5 times higher than that of patients without diabetes mellitus. Transsphenoidal pituitary tumor surgery is the gold standard in the treatment of acromegaly, and many studies have confirmed that surgery can effectively improve the patients’ glucose tolerance status and correct the hypersecretion of growth hormone (GH) and insulin-like growth factor (IGF-1). Recent studies in our department have found that surgery can significantly improve patients’ blood glucose, GH and IGF-1 levels, and that the magnitude of postoperative decreases in patients’ fasting glucose, postprandial glucose, and serum IGF-1 levels are related to patients’ preoperative glucose tolerance status (with pre-diabetic patients showing a higher rate of improvement than diabetic patients). Therefore, early detection and early diagnosis of the disease should be strengthened to control patients in pre-diabetes, which will help patients improve their postoperative glucose tolerance status. For patients who have combined diabetes mellitus, surgical treatment should be considered while actively controlling GH and IGF-1, in order to minimize the risk of cardiovascular disease caused by abnormal glucose metabolism, improve the prognosis of patients, and prolong the life expectancy of patients.