Observational studyDiabetes care2025
Prevalence of Hypercortisolism in Difficult-to-Control Type 2 Diabetes.
Observational study in Diabetes care, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
20 citing papers in PubMed.
- Inadequately Controlled Type 2 Diabetes and Hypercortisolism: Improved Glycemia With Mifepristone Treatment.Diabetes care · 2025Trial
- Hypercortisolism in Type 2 Diabetes with Treatment-Resistant Hyperglycemia: A Treatable Metabolic Phenotype?Endocrinology and metabolism (Seoul, Korea) · 2026Article
- Is Hypercortisolism Treatable? Which Patients Should Be Treated and How-A Practical Guide for Clinicians.Diabetes, obesity & metabolism · 2026Review
- Hypercortisolism: An Under-Recognised Pathway Linked to Multi-System Complications.Diabetes, obesity & metabolism · 2026Review
- Hypercortisolism: Causes, Consequences and Clinical Significance - A Review of Pathophysiology.Diabetes, obesity & metabolism · 2026Review
- How Common Is Hypercortisolism in Patients With Hypertension? Risk Factors, Epidemiology, and Making a Diagnosis.Diabetes, obesity & metabolism · 2026Review
- How Common Is Hypercortisolism in Patients With Type 2 Diabetes? Risk Factors, Epidemiology, and Making a Diagnosis Using a Dexamethasone Suppression Test.Diabetes, obesity & metabolism · 2026Review
- Importance of Hypercortisolism in BP Control, Cardiovascular Risk and in Patients With Difficult-to-Control Hypertension: An Overview for Primary Care Physicians.Diabetes, obesity & metabolism · 2026Review
- Revisiting Insulin Resistance in the Pathophysiology of Type 2 Diabetes Mellitus: A Multi-Organ Perspective.Diabetes & metabolism journal · 2026Review
- Resistant hypertension, hyperaldosteronism, and the emerging understanding of hypercortisolism.Current opinion in cardiology · 2026Review
- Glucose-dependent dynamics of glucagon, cortisol and adrenocorticotropic hormone before and after gastric bypass.Journal of the Endocrine Society · 2026Article
- Response to comment on Buse et al. Prevalence of Hypercortisolism in Difficult-to-Control Type 2 Diabetes. Diabetes Care 2025;48:2012-2020.Diabetes care · 2026Article
- Investigating Endogenous Hypercortisolism Prevalence in a U.S. Population With Resistant Hypertension: MOMENTUM Rationale and Design.JACC. Advances · 2026Article
- The roles, mechanisms, and therapeutic implications of glucocorticoids in glucose and lipid metabolism.Military Medical Research · 2026Review
- Review
- Unmasking Hypercortisolism in Difficult-to-Control Type 2 Diabetes: A Useful Paradigm Shift?Diabetes care · 2025Article
- Article
- Breaking Through Difficult-to-Control T2D: Targeting Hypercortisolism.Federal practitioner : for the health care professionals of the VA, DoD, and PHS · 2025Article
- Identification of Endogenous Hypercortisolism and the Effect of Mifepristone Treatment in Patients With Difficult-to-Manage Diabetes: A Case Series.Diabetes spectrum : a publication of the American Diabetes Association · 2025Article
- The Modern Presentation, Etiology, and Rate of Occurrence of Cushing Syndrome Differs when Compared to Prior Population-Based Studies.AACE endocrinology and diabetesArticle
Corrections and comments
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Authors and funding
27 authors.
Funding
Abstract
objectiveDespite the use of multiple glucose-lowering medications, glycemic targets are not met in a significant fraction of people with type 2 diabetes. In this prospective, observational study we assessed the prevalence of hypercortisolism, a potential contributing factor to inadequate glucose control. RESEARCH DESIGN AND
methodsIndividuals with type 2 diabetes and HbA1c 7.5%-11.5% (58-102 mmol/mol) on two or more glucose-lowering medications with or without micro-/macrovascular complications or taking multiple blood pressure-lowering medications were screened with a 1-mg dexamethasone suppression test. Common causes of false-positive DSTs were excluded. The primary end point was the prevalence of hypercortisolism, defined as post-DST cortisol >1.8 μg/dL (50 nmol/L). Characteristics associated with hypercortisolism were assessed with multiple logistic regression. The percentage and characteristics of participants with hypercortisolism and adrenal imaging abnormalities were also assessed.
resultsPost-DST cortisol was unsuppressed in 252 of 1,057 participants (prevalence 23.8%; 95% CI 21.3, 26.5). Hypercortisolism prevalence was 33.3% among participants with cardiac disorders and 36.6% among those taking three or more blood pressure-lowering medications. Adrenal imaging abnormalities were reported in 34.7% of participants with hypercortisolism. Use of sodium-glucose cotransporter 2 inhibitors (odds ratio 1.558), maximum-dose glucagon-like peptide 1 receptor agonists (1.544), tirzepatide (1.981), or a higher number of blood pressure-lowering medications (1.390); older age (1.316); BMI <30 kg/m2 (1.639); non-Latino/Hispanic ethnicity (3.718); and use of fibrates (2.676) or analgesics (1.457) were associated with higher prevalence (all P < 0.03).
conclusionsHypercortisolism was associated with hyperglycemia in approximately one-quarter of individuals with inadequately controlled type 2 diabetes despite multiple medications.
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