Endocrine Abstracts

Introduction: Cortisol has numerous actions on glucose metabolism and insulin action which explain the frequency of glucose abnormalities in Cushing’s syndrome (CS). The aim of our work was to assess the prevalence and characteristics of diabetes in CS.

Material and methods: This is a retrospective study concerning 51 CS (44F/7M) in whom we looked for the presence of diabetes either by fasting glycaemia or 75 g oral glucose tolerance test. Thereafter, we looked for the characteristics of diabetes in CS. CS was secondary to Cushing’s disease in 82% and to adrenal adenoma in 18%.

Results: 55% of patients have diabetes. Among diabetic patients, 39% have high blood pressure and 42% have a family background of diabetes. 40% of diabetics were treated with oral treatment, 25% with insulin and 35% were on life style therapy. Mean age was 31.92±10.26 years; it was 31.62±10.54 years in patients with diabetes vs 32.45±10.04 years in patients without diabetes. Mean BMI was 31.47±7.33 kg/m²; it was 31.30±7.77 kg/m² in patients with diabetes vs 31.89±6.47 kg/m² in patients without diabetes. Diabetic retinopathy was present in 10% and diabetic neuropathy in 5%. After treatment of CS diabetes resolved in 40% and persisted in 60%.

Conclusion: Diabetes mellitus is frequent in cortisol excess states, the high frequency of diabetes in our study may be explained by preexistent undiagnosed diabetes as diabetes persisted in 60% after resolution of CS.