Relationship between type 2 diabetes mellitus and hypothalamic-pituitary-adrenal axis.

03:27 EST 1st March 2015 | BioPortfolio

Summary of "Relationship between type 2 diabetes mellitus and hypothalamic-pituitary-adrenal axis."

Hypercortisolism often leads to impaired glucose tolerance or type 2 diabetes mellitus. On the other hand, changes in the regulation of hypothalamic-pituitary-adrenal axis become a matter of debate in patients with type 2 diabetes mellitus/metabolic syndrome. PATIENTS, MATERIALS, AND
Authors assessed the hypothalamic-pituitary-adrenal axis activity and subclinical Cushing's syndrome occurrence in 50 patients with type 2 diabetes mellitus in comparison to 25 sex-, age-, and BMI-matched control nondiabetic subjects. 1 mg dexamethasone suppression test with NIH recommended cut-off level for adrenal incidentaloma (serum cortisol after suppression > 138 nmol/l) was used to postulate the diagnosis of subclinical hypercortisolism.
There were no significant differences in serum ACTH, DHEA-S, baseline serum cortisol as well as serum cortisol after suppression of 1 mg dexamethasone/subclinical Cushing's syndrome prevalence in both diabetic and control groups (18 vs. 24% respectively, p = 0.54) and there was no relation to the type of treatment (OAD vs. insulin) in group of diabetics. When divided according to age, diabetics older than 60 years suppressed their serum cortisol significantly worse than their age-related controls (99.3 vs. 85.5 nmol/l, p = 0.0001). Furthermore, diabetics did not show an age-related decrease in DHEA-S levels, whereas controls did (r = -0.302, p = 0.033; r = -0.596, p = 0.0017 respectively). Within the group of diabetics, a positive correlation between C-peptid levels and baseline serum cortisol/DHEA-S levels was detected as well (r = 0.445, p = 0.001 and r = 0.339, p = 0.017 respectively).
Our data show relatively high but comparable lack of cortisol suppression in both diabetic and control groups; however, we consider the subclinical Cushing's syndrome diagnose to be criteria dependent. There is no dependence of type of diabetes treatment (OAD vs. insulin) on HPA axis activity. Our results might indicate the possible role of cortisol in pathogenesis of type 2 diabetes mellitus in patients with metabolic syndrome as well as possible protective role of DHEA-S within the frame of secondary contraregulatory mechanisms aimed to improve insulin sensitivity and reduce the hyperinsulinemia.


1st Department of Internal Medicine, L. Pasteur University Hospital and Medical Faculty of P. J. Šafárik University, Košice, Slovakia,

Journal Details

This article was published in the following journal.

Name: Wiener klinische Wochenschrift
ISSN: 1613-7671


PubMed Articles [16907 Associated PubMed Articles listed on BioPortfolio]

Neurosteroid, GABAergic and hypothalamic pituitary adrenal (HPA) axis regulation: what is the current state of knowledge in humans?

A robust epidemiological literature suggests an association between chronic stress and the development of affective disorders. However, the precise biological underpinnings of this relationship remain...

Is there any relationship between medication compliance and affective temperaments in patients with type 2 diabetes?

Type 2 diabetes mellitus (DM) is the most common type of diabetes.The number of patients with this disease is expected torise in future. Given the increasing prevalence of diabetes, there is an urgent...

All-cause mortality and estimated renal function in type 2 diabetes mellitus outpatients: Is there a relationship with the equation used?

We investigated the relationship between serum creatinine (SCr) and estimated glomerular filtration rate (eGFR), evaluated by different formulae, and all-cause mortality (ACM) in type 2 diabetes melli...

Dexamethasone and Hypothalamic-Pituitary-Adrenal Axis Suppression After Transsphenoidal Pituitary Surgery.

Dexamethasone PONV-Prophylaxis Alters the Hypothalamic-Pituitary-Adrenal Axis After Transsphenoidal Pituitary Surgery.

Clinical Trials [4384 Associated Clinical Trials listed on BioPortfolio]

Study of the Effects of Ciclesonide on Hypothalamic-Pituitary-Adrenal (HPA) Axis

To demonstrate the effects of ciclesonide applied as a nasal aerosol and ciclesonide aqueous (AQ) nasal spray on hypothalamic-pituitary-adrenal axis.

Study of Depression, Peptides, and Steroids in Cushing's Syndrome

OBJECTIVES: I. Study the relationship between dysregulation of the hypothalamic-pituitary-adrenal (HPA) axis and disorders of mood, vegetative function, and cognition in patients with Cus...

Adrenal Function in Critical Illness

An appropriate hypothalamic-pituitary-adrenal (HPA) axis response is required to survive critical illness. Primary adrenal insufficiency, relative adrenal insufficiency, tissue resistance ...

Safety and Tolerability Study of Oral LGD-6972 for Type 2 Diabetes Mellitus

Ligand Pharmaceuticals Incorporated is developing LGD-6972, a novel, orally-bioavailable addition to diet and exercise to improve glycemic control in adults with type 2 diabetes mellitus. ...

Metformin Add-on Study in Patients With Type 2 Diabetes Mellitus

The purpose of this study is to determine the safety and efficacy of an investigational drug in patients with type 2 diabetes mellitus.

Medical and Biotech [MESH] Definitions

A subclass of DIABETES MELLITUS that is not INSULIN-responsive or dependent (NIDDM). It is characterized initially by INSULIN RESISTANCE and HYPERINSULINEMIA; and eventually by GLUCOSE INTOLERANCE; HYPERGLYCEMIA; and overt diabetes. Type II diabetes mellitus is no longer considered a disease exclusively found in adults. Patients seldom develop KETOSIS but often exhibit OBESITY.

The time period before the development of symptomatic diabetes. For example, certain risk factors can be observed in subjects who subsequently develop INSULIN RESISTANCE as in type 2 diabetes (DIABETES MELLITUS, TYPE 2).

The interactions between the anterior pituitary and adrenal glands, in which corticotropin (ACTH) stimulates the adrenal cortex and adrenal cortical hormones suppress the production of corticotropin by the anterior pituitary.

A subtype of DIABETES MELLITUS that is characterized by INSULIN deficiency. It is manifested by the sudden onset of severe HYPERGLYCEMIA, rapid progression to DIABETIC KETOACIDOSIS, and DEATH unless treated with insulin. The disease may occur at any age, but is most common in childhood or adolescence.

A type of diabetes mellitus that is characterized by severe INSULIN RESISTANCE and LIPODYSTROPHY. The latter may be generalized, partial, acquired, or congenital (LIPODYSTROPHY, CONGENITAL GENERALIZED).

Search BioPortfolio:

Relevant Topics

Latest News Clinical Trials Research Drugs Reports Corporate
Endocrinology is the study of the endocrine glands and the hormones that they secrete (Oxford Medical Dictionary). There are several groups of hormones; Reproductive/Sex hormones such as FSH, LH, Oestrogen and Testosterone can affect fertility, se...

Top five promising drugs Phase I (February 2014)
Latest News Clinical Trials Research Drugs Reports Corporate
THE FIVE MOST PROMISING DRUGS ENTERING PHASE I TRIALS - February 2014 Drug Disease Company HTL-9936 Cognitive impairment Heptares Therapeutics BIOD-531 Type 2 diabetes ...