Increased urinary-free cortisol outputs in diabetic patients.

We previously reported that diabetic patients show evidence of dysregulation of the hypothalamic-pituitary-adrenal (HPA) axis. To extend this work, we examined urinary-free cortisol (UFC) outputs in diabetic patients and whether or not they relate to diabetic complications. We compared a group of 35 insulin-dependent diabetic outpatients with a group of 32 normal controls for 24-h UFC outputs and examined the patients for relationship between UFC outputs and diabetic complications. Diabetic patients had significantly greater 24-h UFC outputs than controls. There was a significant positive correlation between 24-h UFC outputs and duration of diabetes. There were trends for patients with either diabetic retinopathy or diabetic cardiovascular complications to have higher 24-h UFC outputs than patients without these complications. These results further show that diabetic patients have mild dysregulation of the HPA axis. This dysregulation is related to longer duration of diabetes. A larger sample is needed to examine further for a relationship to diabetic complications.