title: Cushing's syndrome in type 2 diabetes patients with poor glycemic control.
abstract: Cushing's syndrome may be more frequent in some specific patient groups such as type 2 diabetes and obesity. The aim of this study was to investigate the prevalence of Cushing's syndrome in outpatients with type 2 diabetes with poor glycemic control despite at least 3-months insulin therapy. Outpatients with type 2 diabetes whose glycemic control is poor (Hb Alc value >7 %) despite receiving at least 3-months long insulin treatment (insulin alone or insulin with oral antidiabetics) were included. Patients with classic features of Cushing's syndrome were excluded. Overnight 1 mg dexamethasone suppression test (DST) was performed as a screening test. A total of 277 patients with type 2 diabetes whose glycemic control is poor (Hb Alc value >7 %) despite insulin therapy were included. Two of the 277 patients with type 2 diabetes were diagnosed with Cushing's syndrome (0.72 %). Hypertension was statistically more frequent in the patients with cortisol levels ≥1.8 μg/dL than the patients with cortisol levels <1.8 μg/dL after overnight 1 mg DST (p = 0.041). Statistically significant correlation was determined between cortisol levels after 1 mg DST and age, daily insulin dose (r = 0.266 and p < 0.001, r = 0.163 and p = 0.008, respectively). According to our findings, the prevalence of Cushing's syndrome among patients with type 2 diabetes with poor glycemic control despite insulin therapy is much higher than in the general population. The patients with type 2 diabetes with poor glycemic control despite at least three months of insulin therapy should be additionally tested for Cushing's syndrome if they have high dose insülin requirements.
authors.affiliation: Department of Endocrinology and Metabolic Diseases, Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey, askn79@yahoo.com.
authors.forename: Askin
authors.initials: A
authors.lastname: Gungunes
authors.forename: Mustafa
authors.initials: M
authors.lastname: Sahin
authors.forename: Taner
authors.initials: T
authors.lastname: Demirci
authors.forename: Bekir
authors.initials: B
authors.lastname: Ucan
authors.forename: Evrim
authors.initials: E
authors.lastname: Cakir
authors.forename: Muyesser Sayki
authors.initials: MS
authors.lastname: Arslan
authors.forename: Ilknur Ozturk
authors.initials: IO
authors.lastname: Unsal
authors.forename: Basak
authors.initials: B
authors.lastname: Karbek
authors.forename: Mustafa
authors.initials: M
authors.lastname: Calıskan
authors.forename: Mustafa
authors.initials: M
authors.lastname: Ozbek
authors.forename: Erman
authors.initials: E
authors.lastname: Cakal
authors.forename: Tuncay
authors.initials: T
authors.lastname: Delibasi
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001786:Blood Glucose; D015897:Comorbidity; D003480:Cushing Syndrome / Q000097:blood / Q000453:epidemiology*; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000188:drug therapy* / Q000453:epidemiology; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000097:blood*; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D007328:Insulin / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D015995:Prevalence
chemical_list: D001786:Blood Glucose; D007004:Hypoglycemic Agents; D007328:Insulin; D006854:Hydrocortisone
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