High levels of growth hormone and insulin-like growth factor 1 contribute to tissue proliferation and hypertrophy in patients with acromegaly mostly due to growth hormone-secreting pituitary adenoma. Some phenotypic features of acromegaly that make us to consider in the differential diagnosis are excessive growth of the hands and feet and coarsening facial features. Growth hormone also induces lipolytic activities and insulin resistance, so patients with acromegaly often present with impaired glucose tolerance and type 2 diabetes mellitus. We wanted to share a case with treatment-resistant hyperglycemia which is the cause of presentation of acromegaly.