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Cushing’s syndrome in a clinic population with diabetes

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Abstract Background:

A recent report has suggested that occult Cushing’s syndrome (CS) may be present in a significant number of patients with type 2 diabetes mellitus. The aim of this study was to determine whether any patients in our clinic population with diabetes had this condition. Methods:

One hundred and seventy-one consecutive overweight attendees at the diabetic clinic were enrolled in a study to assess the presence of occult CS. The initial screen was with the 1 mg overnight dexamethasone suppression test and follow-up testing, where indicated was with a 24 h collection for urine-free cortisol. Results:

Thirty-one of 171 patients had a positive result from the overnight dexamethasone suppression test. Follow-up testing with 24 h urine-free cortisol reduced the number of patients with positive results to 3. Two of these were shown to have alcoholic pseudo-CS. The third patient has had several high urine-free cortisol results, in the presence of normal scans of pituitary and adrenals. He has no stigmata of CS and is being observed. Conclusion:

Based on the results of our study, there would appear to be little value in screening type 2 diabetics for CS, in the absence of clinical suspicion.

Keywords: Cushing’s syndrome; diabetes; overnight dexamethasone suppression test

Document Type: Research Article


Affiliations: 1: Department of Diabetes and Endocrinology 2: ANU Medical School and ACT Pathology, The Canberra Hospital, Canberra, Australian Capital Territory, Australia

Publication date: 2008-03-01

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