Is Diabetes in Cushing’s Syndrome a Consequence of Hypercortisolism?

Eur J Endocrinol. 2013 Nov 19. [Epub ahead of print]

Is Diabetes in Cushing syndrome only a consequence of hypercortisolism?

Source

C Giordano, Dipartimento di Medicina Interna e Specialistica (Di.Bi.Mi.S) Sezione di Endocrinologia e Malattie del Metabolismo, University of Palermo, Palermo, Italy.

Abstract

OBJECTIVE:

Diabetes mellitus (DM) is one of the most frequent complications of Cushing syndrome (CS). Aim of the study was to define the changes in insulin sensitivity and/or secretion in relation to glucose tolerance categories in newly diagnosed CS patients.

DESIGN:

Cross-sectional study on 140 patients with CS.

METHODS:

113 women (80 with pituitary disease and 33 with adrenal disease, aged 41.7±15.7 yr) and 27 men (19 with pituitary disease and 8 with adrenal disease, aged 38.1±20.01 yr) at diagnosis were divided according to glucose tolerance into normal glucose tolerance (CS/NGT), impaired fasting glucose and/or impaired glucose tolerance (CS/prediabetes) and diabetes (CS/DM).

RESULTS:

71 patients belonged to CS/NGT (49.3%), 26 (18.5%) to CS/prediabetes and 43 (30.8%) to CS/DM. Significant increasing trends in the prevalence of family history of diabetes (p<0.001), metabolic syndrome (p<0.001), age (p<0.001) and waist circumference (p=0.043) and decreasing trends in HOMAβ (p<0.001)and Oral Dispositional Index (DIo) (p<0.002) were observed among the groups. No significant trend in fasting insulin, AUC INS, ISI-Matsuda and VAI was detected.

CONCLUSIONS:

Impairment of glucose tolerance is characterized by the inability of β-cells to adequately compensate insulin resistance through increased insulin secretion. Age, genetic predisposition and lifestyle, in combination with duration and degree of hypercortisolism, strongly contribute to the impairment of glucose tolerance in the natural history of CS. A careful phenotypic evaluation of glucose tolerance defects in patients with CS proves useful for the identification of patients at high risk for metabolic complications.

PMID:
24255133
[PubMed – as supplied by publisher]

Interview with Miriam K (Meeks089), Pituitary Success Story

Miriam writes in her bio:

“I suffered for eight long years with Cushings disease . I had surgery on August 1 , 2012 , I look like a different person , and act like a different person. I would love to share my journy . One that was an emotional roller coaster .

It was a long hellish journey .However I would not trade it for anything else in the world.

Although I suffered immensly, Cushings has made me who I am today. I have become strong from this disease. Although I suffered many symptoms, the emotional ones were by far the worst.

I would love to be interveiwed because I vowed when I was ill to help people when I got better.

I want to give people hope .”

MaryONote:  Miriam will be interviewed on BlogTalkRadio podcasts December 4, 2013.

Brigham & Womens Hospital’s Pituitary Day 2014

BWH_Pit_Day

In partnership with the Brain Science Foundation, the Brigham and Women’s Hospital Pituitary Neuroendocrine Center is pleased to present

Pituitary Day 2014

Saturday, March 29, 2013
8 AM – 5 PM
Bornstein Amphitheater
at Brigham & Women’s Hospital
75 Francis Street
Boston, MA

This conference is intended to unite patients, caregivers, family and friends with leading clinicians, researchers, nurses, and other experts to discuss the latest in pituitary diagnosis and treatment. All patients, caregivers, family and friends are welcome!

For more information, please visit brainsciencefoundation.org or call Sarah Donnelly at 781-239-2903.

Webinar: Advances and Limitations of Endoscopic Pituitary Surgery

Presented by Paul Gardner, MD

Check back with us for registration information or contact us at webinar@pituitary.org.

Date: Wednesday, December 4, 2013
Time: 9:00 – 10:00 AM PST

After registering you will receive a confirmation email containing information about joining the Webinar.

November 15 Webinar: “Pituitary Disorders and the Family”

Webinar: “Pituitary Disorders and the Family”
Presented by Jamie L. Banker, Ph.D., Director of Counseling Psychology California Lutheran University
Date: Friday, November 15, 2013
Time: 12:00-1:00 PM PDT 

Seating is limited, register today!
https://www4.gotomeeting.com/register/127537863?utm_source=newsletter_45&utm_medium=email&utm_campaign=webinar-announcement-pituitary-disorders-and-the-family

After registering you will receive a confirmation email containing information about joining the Webinar.
Webinar Information
Chronic illness systemically affects individuals and families, in that the illness impacts the whole system, rather than just the individual with the diagnosis. Health problems can create or exacerbate conflict within a family or support system (Ruddy, Borresen, & Gunn, 2008). This is also the case within families with a family member with an endocrine disorder.

Historically, research on medical illness focused mainly on the identified medical patient, but recent literature shows an ever-growing interest in understanding the physical and mental toll those managing and caring for close relatives with a serious illness or disability (Feigin, Barnetz, & Davidson-Arad, 2008). Family systems theories have influenced this turn, as it becomes clear that focusing on a problem with one family member acknowledges only one part of the affected system.

In this presentation Dr. Banker will talk about what is meant by the “family system,” what is meant by “collaborative’ and “integrated” care, Dr. Banker will identify ways pituitary disorders impact the family system, She will discuss ways family members can positively impact healing and learn what can be the role of a “family therapist” in helping families affected by a pituitary tumor or other endocrine disorder.

Dr. Banker will also talk about her most recent research connecting the early childhood trauma and pituitary disorders.

Learning Objectives
▪ Learn about the primary effects of chronic and/or serious illness on the family
▪ Learn what is meant by the “family system”
▪ Learn what is meant by “collaborative’ and “integrated” care
▪ Identify ways pituitary disorders impact the family system
▪ Learn ways family members can positively impact healing
▪ Learn what can be the role of a “family therapist” in helping families affected by a pituitary tumor or other endocrine disorder

Presenter Bio
Jamie Banker is the Director of Counseling Psychology Masters program and Assistant Professor of Psychology at California Lutheran University in Thousand Oaks California. She is a Licensed Marriage and Family Therapist and has a special interest in integrated behavioral healthcare. She completed a clinical master’s degree at University of San Diego and completed her doctoral degree at Virginia Tech. Dr. Banker was a doctoral intern at Dartmouth College Family Medicine Residency. Dr. Banker has worked in three integrated primary care practices as a therapist and a lecturer. She has published scholarly articles and a few book chapter on integrated healthcare. Now her focus is on training Marriage and Family Therapy students to work in integrated behavioral healthcare sites. She is an AAMFT approved clinical supervisor. Dr. Banker’s research agenda centers on women’s and family’s health. It encompasses topics that are both underserved and burgeoning in the fields of psychology, marriage and family therapy, behavioral medicine, and public health. Dr. Banker’s primary research interests are collaboration between family therapists and medical professionals, family health and training integrated care professionals. These interests all fall under the larger umbrella of improving individuals’ overall healthcare. Her research agenda is focused on decreasing the gap between medical and mental health assessment and treatment. Dr. Banker’s current research is on understanding postpartum depression and disorders of the endocrine system from a biopsychosocial model.