Screening of Cushing’s syndrome in adult patients with newly diagnosed diabetes mellitus
Abstract
OBJECTIVE: Recent studies have shown that a relatively high number of diabetic patients may have unsuspected Cushing's syndrome (CS). The aim of the present study was to screen for CS in adult patients with newly diagnosed diabetes mellitus who were not selected for clinical characteristics, such as poor control and obesity, which may increase the pre-test probability of CS. DESIGN, PATIENTS AND MEASUREMENT: We prospectively evaluated 100 consecutive diabetic patients at diagnosis from 2003 to 2004. No patient had clear Cushingoid features. Screening was performed by using the overnight 1-mg dexamethasone suppression test (DST) after complete recovery from acute concomitant illnesses and attainment of satisfactory glycaemic control. The threshold of adequate suppression after DST was set at 110 nmol/l. RESULTS: Five patients failed to suppress cortisol after DST and underwent a repeated DST and a confirmatory standard 2-day, 2-mg DST after 3-6 months from the baseline evaluation. In one woman, a definitive diagnosis of CS was made by a surgically proven pituitary adenoma, and glycaemic control improved after cure of CS. CONCLUSIONS: The results of the present study support the view that unknown CS is not rare among patients with diabetes mellitus. This is the first demonstration that screening for CS may be feasible at the clinical onset of diabetes in an unselected cohort of patients. Therefore, early diagnosis and treatment of CS may provide the opportunity to improve the prognosis of diabetes.
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The prevalence of previously unsuspected Cushing syndrome in patients with type 2 diabetes ranges from 0% to 9.4%.
“The association between DM and CS has been examined in various studies, which have shown a prevalence of previously unsuspected CS in patients with type DM ranging from % to .% (Table ) (-).”
From Glucose Metabolism Abnormalities in Cushing Syndrome: From Molecular Basis to Clinical Management (2017) · cites this paper as [250]
Reimondo et al. found only one of 100 patients with newly diagnosed diabetes had pituitary-dependent subclinical hypercortisolism.
“However, these figures were partially different in the study of Reimondo et al. (85), in which only one of 100 patients with newly diagnosed diabetes was found to have a pituitary-dependent SH.”
From Diagnosis and Treatment of Subclinical Hypercortisolism (2011) · cites this paper as [85]
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- Authors
- Reimondo, G., Pia, A., Allasino, B., Tassone, F., Bovio, S., Borretta, G., Angeli, A., & Terzolo, M.
- Affiliations
- Ospedale San Luigi Gonzaga (IT)
- Azienda Sanitaria Ospedaliera S.Croce e Carle Cuneo (IT)
- University of Turin (IT)
- Corresponding author
- Reimondo, Giuseppe
- Venue
- Clinical Endocrinology
- Publisher
- Wiley
- Published
- 2007-04-12
- Volume
- 67
- Issue
- 2
- Pages
- 225-229
- ISSN
- 0300-0664 (ISSN-L)
- 1365-2265
- OpenAlex
- W2002763735
- Cited by
- 89
- References
- 24
- Citations by year
- 2026: 1 · 2025: 3 · 2024: 1 · 2023: 2 · 2022: 6 · 2021: 4 · 2020: 1 · 2019: 2 · 2018: 4 · 2017: 5 · 2016: 6 · 2015: 6 · 2014: 5 · 2013: 7 · 2012: 6
- FWCI
- 4.65
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Clinical Endocrinology (publishedVersion)
- PubMed (publishedVersion)
- Institutional Research Information System University of Turin (University of Turin) (submittedVersion)
- Funders
- Università degli Studi di Torino
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Pituitary Gland Disorders and Treatments
- Health Sciences › Medicine › Surgery › Adrenal and Paraganglionic Tumors
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Adrenal Hormones and Disorders
- Keywords
- Cushing's syndrome, diabetes mellitus, screening, dexamethasone suppression test, cortisol, pituitary adenoma, newly diagnosed diabetes, early diagnosis, glycemic control
- MeSH terms
- Adenoma, Adrenocorticotropic Hormone, Adult, Aged, Aged, 80 and over, Corticotropin-Releasing Hormone, Cushing Syndrome, Dexamethasone, Female, Glucocorticoids, Humans, Hydrocortisone, Male, Middle Aged, Pituitary Neoplasms, Prospective Studies, Prevalence, Chi-Square Distribution, Diabetes Complications
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