Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2020 Jun;27(3):140-145.
doi: 10.1097/MED.0000000000000537.

Glucose metabolism in Cushing's syndrome

Anu Sharma  1 , Adrian Vella  2
Affiliations
Review

Glucose metabolism in Cushing's syndrome

Anu Sharma et al. Curr Opin Endocrinol Diabetes Obes. 2020 Jun.

Abstract

Purpose of review: Impairment of glucose metabolism is commonly encountered in Cushing's syndrome. It is the source of significant morbidity and mortality even after successful treatment of Cushing's. This review is to understand the recent advances in understanding the pathophysiology of diabetes mellitus from excess cortisol.

Recent findings: In-vitro studies have led to significant advancement in understanding the molecular effects of cortisol on glucose metabolism. Some of these findings have been translated with human data. There is marked reduction in insulin action and glucose disposal with a concomitant, insufficient increase in insulin secretion. Cortisol has a varied effect on adipose tissue, with increased lipolysis in subcutaneous adipose tissue in the extremities, and increased lipogenesis in visceral and subcutaneous truncal adipose tissue.

Summary: Cushing's syndrome results in marked impairment in insulin action and glucose disposal resulting in hyperglycemia. Further studies are required to understand the effect on incretin secretion and action, gastric emptying, and its varied effect on adipose tissue.

PubMed Disclaimer

Conflict of interest statement

Conflicts of interest

AS has no conflicts of interest.

References

    1. Faggiano A, Pivonello R, Spiezia S, et al. Cardiovascular risk factors and common carotid artery caliber and stiffness in patients with Cushing’s disease during active disease and 1 year after disease remission. J Clin Endocrinol Metab. 2003;88(6):2527–2533. - PubMed
    1. Biering H, Knappe G, Gerl H, Lochs H. [Prevalence of diabetes in acromegaly and Cushing syndrome]. Acta Med Austriaca. 2000;27(1):27–31. - PubMed
    1. Zilio M, Barbot M, Ceccato F, et al. Diagnosis and complications of Cushing’s disease: gender-related differences. Clin Endocrinol (Oxf). 2014;80(3):403–410. - PubMed
    1. Giordano C, Guarnotta V, Pivonello R, et al. Is diabetes in Cushing’s syndrome only a consequence of hypercortisolism? Eur J Endocrinol. 2014;170(2):311–319. - PubMed
    1. Bolland MJ, Holdaway IM, Berkeley JE, et al. Mortality and morbidity in Cushing’s syndrome in New Zealand. Clin Endocrinol (Oxf). 2011;75(4):436–442. - PubMed