An adult patient presents with backache and an abnormal increase in shoe size acutely, the disorder acromegaly can be considered. Acromegaly is described as the excess growth hormone production and typically presents as course facial features, and large hands and feet. Since growth hormone is primarily a diabetogenic hormone, a 100-g OGTT test will likely reveal diabetes mellitus or an impaired glucose tolerance. A blood sample can be used to determine the levels of insulin-like growth factor (IGF) and an elevated IGF may indicate acromegaly. Urinalysis may show sugar in the urine due to excretion of glucose since blood sugar in acromegaly is abnormally increased.