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Endocrine Abstracts (2017) 49 EP919 | DOI: 10.1530/endoabs.49.EP919

1Hospital de Clinicas de Porto Alegre, Porto Alegre, Brazil; 2Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.


Introduction: Diabetes mellitus (DM) is an expected condition in Cushing syndrome (CS) but there are few data about prevalence and factors associated to occurrence of DM in these patients.

Objective: To determine the main aspects of DM in CS through a systematic review (SR) of the literature.

Methods: MEDLINE and LILACS were searched for studies published until March, 2016. Search strategy comprised the terms “Diabetes Mellitus”, “Glucose Intolerance”, “Hyperglycemia”, “Cushing Syndrome”, “Pituitary ACTH hypersecretion”, “diabete melito”, “Cushing”. Observational/interventional studies in patients with endogenous CS with characterization of DM were included. We excluded case reports, animal models, and studies about exogenous hypercortisolism or subclinical CS.

Results: The initial search yielded 726 titles, 58 were full-text reviewed. Of these, 12 were included in RS. Seven studies (all cross-sectional) accessed DM prevalence. Most patients were women (93.5%) aged 40–50 years, with disease duration between 29 and 180 months. Pituitary, adrenal and ectopic-ACTH were origin of CS in 325 (70.65%), 134 (29%) and 2 (0.5%) patients, respectively. DM prevalence ranged from 17 to 47%. Four studies evaluated the role of body mass index (BMI) on DM occurrence, but none of them found a statistically significant difference. Two studies demonstrated a higher risk of DM in older ages at CS diagnosis. The correlation of DM and severity of hypercortisolism was analysed in four articles and two of them presented a positive result. The effect of CS remission on DM cure was accessed by two studies, with discordant results. DM was associated with higher mortality. Three studies (open-label trials) analysed effect of CS drug therapy on glycaemic control. Mifepristone demonstrated a diabetes improvement after 6 months, as rosiglitazone after 30–120 days.

Conclusion: DM is a frequent CS comorbidity and its occurrence seems to depend on age at diagnosis and disease duration. If CS remission leads to DM remission is still uncertain.

Volume 49

19th European Congress of Endocrinology

Lisbon, Portugal
20 May 2017 - 23 May 2017

European Society of Endocrinology 

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