Anu Sharma1, Adrian Vella2. 1. Division of Diabetes and Endocrinology, University of Utah School of Medicine, Salt Lake City, Utah. 2. Division of Endocrinology, Diabetes, Metabolism and Nutrition, Mayo College of Medicine, Rochester, Minnesota, USA.
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.
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.
Authors: A Colao; R Pivonello; S Spiezia; A Faggiano; D Ferone; M Filippella; P Marzullo; G Cerbone; M Siciliani; G Lombardi Journal: J Clin Endocrinol Metab Date: 1999-08 Impact factor: 5.958
Authors: Beth T Vander Kooi; Hiroshi Onuma; James K Oeser; Christina A Svitek; Shelley R Allen; Craig W Vander Kooi; Walter J Chazin; Richard M O'Brien Journal: Mol Endocrinol Date: 2005-07-21
Authors: Stuart A Morgan; Mark Sherlock; Laura L Gathercole; Gareth G Lavery; Carol Lenaghan; Iwona J Bujalska; David Laber; Alice Yu; Gemma Convey; Rachel Mayers; Krisztina Hegyi; Jaswinder K Sethi; Paul M Stewart; David M Smith; Jeremy W Tomlinson Journal: Diabetes Date: 2009-08-12 Impact factor: 9.461
Authors: Alex Rafacho; Luiz M Gonçalves-Neto; Junia C Santos-Silva; Paloma Alonso-Magdalena; Beatriz Merino; Sebastião R Taboga; Everardo M Carneiro; Antonio C Boschero; Angel Nadal; Ivan Quesada Journal: PLoS One Date: 2014-04-04 Impact factor: 3.240
Authors: Adam Sadowski; Ryan S Wexler; Douglas Hanes; Lita Buttolph; Tediana Torrens; Jillian Moehle; Hadil Sarrar; Joanna Harnett; David T Zava; Ryan Bradley Journal: BMC Complement Med Ther Date: 2022-05-05