Medical treatment of Cushing's disease with concurrent diabetes mellitus.
Cushing’s disease
diabetes mellitus
glucose metabolism
insulin resistance
medical therapies
metabolic comorbidities
Journal
Frontiers in endocrinology
ISSN: 1664-2392
Titre abrégé: Front Endocrinol (Lausanne)
Pays: Switzerland
ID NLM: 101555782
Informations de publication
Date de publication:
2023
2023
Historique:
received:
25
02
2023
accepted:
03
04
2023
medline:
5
5
2023
pubmed:
4
5
2023
entrez:
4
5
2023
Statut:
epublish
Résumé
Cushing's disease (CD) is a severe endocrine disorder characterized by chronic hypercortisolaemia secondary to an overproduction of adrenocorticotropic hormone (ACTH) by a pituitary adenoma. Cortisol excess impairs normal glucose homeostasis through many pathophysiological mechanisms. The varying degrees of glucose intolerance, including impaired fasting glucose, impaired glucose tolerance, and Diabetes Mellitus (DM) are commonly observed in patients with CD and contribute to significant morbidity and mortality. Although definitive surgical treatment of ACTH-secreting tumors remains the most effective therapy to control both cortisol levels and glucose metabolism, nearly one-third of patients present with persistent or recurrent disease and require additional treatments. In recent years, several medical therapies demonstrated prominent clinical efficacy in the management of patients with CD for whom surgery was non-curative or for those who are ineligible to undergo surgical treatment. Cortisol-lowering medications may have different effects on glucose metabolism, partially independent of their role in normalizing hypercortisolaemia. The expanding therapeutic landscape offers new opportunities for the tailored therapy of patients with CD who present with glucose intolerance or DM, however, additional clinical studies are needed to determine the optimal management strategies. In this article, we discuss the pathophysiology of impaired glucose metabolism caused by cortisol excess and review the clinical efficacy of medical therapies of CD, with particular emphasis on their effects on glucose homeostasis.
Identifiants
pubmed: 37139336
doi: 10.3389/fendo.2023.1174119
pmc: PMC10150952
doi:
Substances chimiques
Hydrocortisone
WI4X0X7BPJ
Adrenocorticotropic Hormone
9002-60-2
Glucose
IY9XDZ35W2
Types de publication
Journal Article
Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
1174119Informations de copyright
Copyright © 2023 Mehlich, Bolanowski, Mehlich and Witek.
Déclaration de conflit d'intérêts
PW and MB received lecture fees and travel grants form Novartis, IPSEN, Recordati Rare Diseases and Strongbridge Biopharma. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be constructed as a potential conflict of interest.
Références
JAMA. 2010 Apr 14;303(14):1410-8
pubmed: 20388897
Diabetes Ther. 2018 Oct;9(5):1757-1773
pubmed: 30039249
Am J Physiol. 1984 Nov;247(5 Pt 1):E592-6
pubmed: 6388353
Clin Endocrinol (Oxf). 2014 May;80(5):621-8
pubmed: 24611992
Br Med J. 1977 Jul 23;2(6081):215-7
pubmed: 195666
Eur J Endocrinol. 2009 Jun;160(6):1003-10
pubmed: 19289534
Eur J Endocrinol. 2013 Oct 08;169(5):715-23
pubmed: 23996696
J Clin Endocrinol Metab. 2013 Aug;98(8):3446-53
pubmed: 23733372
CMAJ. 2009 Jan 6;180(1):32-9
pubmed: 19073651
Pituitary. 2022 Dec;25(6):911-926
pubmed: 36085339
J Pharmacol Exp Ther. 2010 Jul;334(1):232-43
pubmed: 20354176
Endokrynol Pol. 2012;63(4):277-85
pubmed: 22933163
Endocrine. 2016 Oct;54(1):1-2
pubmed: 27388591
FASEB J. 2008 Jun;22(6):1672-83
pubmed: 18198220
J Endocrinol. 2018 Jan;236(1):R69-R91
pubmed: 29051192
Neuroendocrinology. 2010;92 Suppl 1:77-81
pubmed: 20829623
J Clin Endocrinol Metab. 2001 Jan;86(1):117-23
pubmed: 11231987
Eur J Endocrinol. 2011 Sep;165(3):383-92
pubmed: 21715416
Eur J Endocrinol. 2013 Dec 21;170(2):311-9
pubmed: 24255133
Exp Cell Res. 1983 Aug;147(1):177-82
pubmed: 6617759
J Med Chem. 2017 Apr 27;60(8):3405-3421
pubmed: 28368581
J Endocrinol. 2013 Jan 02;216(1):T37-45
pubmed: 22991412
N Engl J Med. 2007 Jun 7;356(23):2372-80
pubmed: 17554118
Endocr Rev. 2017 Jun 1;38(3):189-219
pubmed: 28368467
J Clin Endocrinol Metab. 2011 Sep;96(9):2796-804
pubmed: 21752886
Eur J Endocrinol. 2016 Jan;174(1):17-24
pubmed: 26582653
Clin Endocrinol (Oxf). 2014 Apr;80(4):562-9
pubmed: 24102404
Mol Endocrinol. 1998 Apr;12(4):482-91
pubmed: 9544984
Front Endocrinol (Lausanne). 2020 Dec 08;11:648
pubmed: 33363514
Diabetes Obes Metab. 2021 Jan;23(1):58-67
pubmed: 32869474
Diabetes Obes Metab. 2017 Mar;19(3):348-355
pubmed: 27862830
J Neurosurg. 2008 Jan;108(1):9-18
pubmed: 18173305
Proc Natl Acad Sci U S A. 1980 Oct;77(10):5711-5
pubmed: 6255461
Endocrine. 2017 Aug;57(2):314-325
pubmed: 27738887
Clin Endocrinol (Oxf). 2011 Sep;75(3):354-60
pubmed: 21521323
Am J Physiol Endocrinol Metab. 2009 Apr;296(4):E681-9
pubmed: 19158320
Sci Rep. 2013;3:2573
pubmed: 23999235
Diabetes Care. 2013 Sep;36(9):e147-8
pubmed: 23970725
Eur J Endocrinol. 2022 Nov 24;187(6):859-871
pubmed: 36251618
Metabolism. 1990 Mar;39(3):251-8
pubmed: 2407926
Front Endocrinol (Lausanne). 2021 Apr 07;12:595894
pubmed: 33897615
Eur J Endocrinol. 2008 Jan;158(1):91-9
pubmed: 18166822
Clin Endocrinol (Oxf). 2014 Sep;81(3):408-17
pubmed: 24533697
J Clin Endocrinol Metab. 2004 May;89(5):2452-62
pubmed: 15126577
J Clin Invest. 1993 Oct;92(4):2065-72
pubmed: 7691892
World J Diabetes. 2010 Jul 15;1(3):99-100
pubmed: 21537433
Endocr Pract. 2010 Nov-Dec;16(6):968-76
pubmed: 20497937
Metabolism. 1998 Jan;47(1):3-6
pubmed: 9440469
Endocr Rev. 2017 Feb 1;38(1):3-45
pubmed: 27749086
J Clin Pharmacol. 2012 Jul;52(7):1017-27
pubmed: 21673137
Curr Diab Rep. 2017 May;17(5):32
pubmed: 28364356
Am J Physiol. 1996 Jan;270(1 Pt 1):E36-42
pubmed: 8772471
J Clin Endocrinol Metab. 1975 Sep;41(3):600-10
pubmed: 1159064
Eur J Endocrinol. 2018 May;178(5):447-458
pubmed: 29472378
J Clin Endocrinol Metab. 2014 May;99(5):1623-30
pubmed: 24471573
Lancet Diabetes Endocrinol. 2019 Nov;7(11):855-865
pubmed: 31542384
Endocrinol Metab Clin North Am. 2014 Mar;43(1):75-102
pubmed: 24582093
Clin Epidemiol. 2015 Apr 17;7:281-93
pubmed: 25945066
Compr Physiol. 2020 Jul 8;10(3):785-809
pubmed: 32940941
Lancet Diabetes Endocrinol. 2016 Jul;4(7):611-29
pubmed: 27177728
Pituitary. 2016 Apr;19(2):138-48
pubmed: 26542280
Pituitary. 2021 Dec;24(6):887-903
pubmed: 34275099
J Endocrinol. 2019 Aug;242(2):65-77
pubmed: 31117053
J Clin Endocrinol Metab. 2019 Aug 1;104(8):3437-3449
pubmed: 31127821
Endocrine. 2019 Jun;64(3):657-672
pubmed: 30968338
Pituitary. 2010 Jun;13(2):123-9
pubmed: 19943118
BMJ Open. 2013 Jan 24;3(1):
pubmed: 23355666
Int J Obes (Lond). 2014 Sep;38(9):1228-33
pubmed: 24430397
Lancet. 2006 Nov 11;368(9548):1696-705
pubmed: 17098089
J Clin Endocrinol Metab. 2009 Jan;94(1):223-30
pubmed: 18957500
Ann Intern Med. 1980 May;92(5):613-9
pubmed: 6247946
Front Endocrinol (Lausanne). 2021 Sep 17;12:732240
pubmed: 34603209
Eur J Endocrinol. 2010 Nov;163(5):709-16
pubmed: 20702648
Clin Endocrinol (Oxf). 2012 Nov;77(5):735-42
pubmed: 22533782
Diabetes Metab. 2013 Feb;39(1):34-41
pubmed: 23228667
J Clin Invest. 1997 Feb 1;99(3):414-23
pubmed: 9022074
Diabetologia. 2002 Jan;45(1):49-55
pubmed: 11845223
Clin Endocrinol (Oxf). 2011 Oct;75(4):436-42
pubmed: 21609352
Lancet Diabetes Endocrinol. 2020 Sep;8(9):748-761
pubmed: 32730798
Front Pharmacol. 2020 Apr 24;11:429
pubmed: 32390830
Exp Clin Endocrinol Diabetes. 2007 Feb;115(2):146-50
pubmed: 17318778
J Clin Endocrinol Metab. 2014 Apr;99(4):1375-83
pubmed: 24423285
N Engl J Med. 1979 Mar 1;300(9):459-64
pubmed: 215912
Pituitary. 2014 Apr;17(2):109-17
pubmed: 23468128
J Clin Endocrinol Metab. 1995 Nov;80(11):3114-20
pubmed: 7593411
Lancet Diabetes Endocrinol. 2021 Dec;9(12):847-875
pubmed: 34687601
Cell. 2004 Apr 30;117(3):399-412
pubmed: 15109499
Life Sci. 2016 Jan 1;144:1-7
pubmed: 26606859
Eur Endocrinol. 2018 Sep;14(2):62-66
pubmed: 30349596
Endocr Rev. 2015 Aug;36(4):385-486
pubmed: 26067718
J Clin Endocrinol Metab. 2009 Jan;94(1):115-22
pubmed: 18957506
Annu Rev Physiol. 2016;78:155-80
pubmed: 26667074
J Clin Endocrinol Metab. 2015 Nov;100(11):4146-54
pubmed: 26353009
Arch Biochem Biophys. 2008 Jun 1;474(1):91-101
pubmed: 18328801
BMC Endocr Disord. 2015 Oct 27;15:63
pubmed: 26507877
Diabetes Obes Metab. 2009 Dec;11(12):1145-52
pubmed: 19758359
Eur J Endocrinol. 2010 Apr;162(4):729-35
pubmed: 20124412
J Endocrinol. 2005 Jan;184(1):219-32
pubmed: 15642798
Int J Mol Sci. 2021 Jan 09;22(2):
pubmed: 33435513
Endocrine. 2017 Jul;57(1):156-165
pubmed: 28597198
Eur J Endocrinol. 2012 Oct;167(4):473-81
pubmed: 22815335
Pituitary. 2016 Oct;19(5):536-43
pubmed: 27405306
Eur J Endocrinol. 2017 Mar;176(3):305-314
pubmed: 28007845
Eur J Clin Invest. 2009 Feb;39(2):81-93
pubmed: 19200161
J Clin Endocrinol Metab. 2013 Jun;98(6):2277-84
pubmed: 23533241
Front Endocrinol (Lausanne). 2018 Jun 05;9:284
pubmed: 29915558
J Clin Endocrinol Metab. 2021 Mar 25;106(4):e1618-e1630
pubmed: 33399817
Front Endocrinol (Lausanne). 2021 Jul 14;12:662865
pubmed: 34335465
J Biol Chem. 1997 Feb 7;272(6):3216-22
pubmed: 9013557
J Clin Endocrinol Metab. 2012 Jun;97(6):2039-49
pubmed: 22466348
Clin Endocrinol (Oxf). 1994 Apr;40(4):479-84
pubmed: 8187313
Diabetes. 2006 May;55(5):1380-90
pubmed: 16644695
J Clin Endocrinol Metab. 2013 Mar;98(3):1022-30
pubmed: 23393167
Horm Metab Res. 2011 Apr;43(4):275-81
pubmed: 21225543
Endocr Relat Cancer. 2012 Nov 09;19(6):R205-23
pubmed: 22936543
J Clin Endocrinol Metab. 2022 Jun 16;107(7):e2882-e2895
pubmed: 35325149
J Clin Endocrinol Metab. 1999 Aug;84(8):2664-72
pubmed: 10443657
Diabetes Res Clin Pract. 2014 Mar;103(3):458-65
pubmed: 24461109
Lancet Diabetes Endocrinol. 2018 Jan;6(1):17-26
pubmed: 29032078
Diabetes Res Clin Pract. 2022 Aug;190:109994
pubmed: 35843312
J Clin Endocrinol Metab. 2010 Feb;95(2):630-8
pubmed: 20022992
Rev Endocr Metab Disord. 2022 Jun;23(3):601-620
pubmed: 35067849
Clin Endocrinol (Oxf). 1991 Aug;35(2):169-78
pubmed: 1657460
Pituitary. 2020 Oct;23(5):534-542
pubmed: 32524277
J Neuroendocrinol. 2022 Aug;34(8):e13113
pubmed: 35312199
Neuroendocrinology. 2020;110(6):477-488
pubmed: 31597135
Pituitary. 2014 Apr;17(2):180-6
pubmed: 23564338
Mol Endocrinol. 2005 Dec;19(12):3001-22
pubmed: 16037130
N Engl J Med. 1971 Jul 29;285(5):243-7
pubmed: 4326256
Endocrine. 2018 Dec;62(3):701-711
pubmed: 30014438
Diabetologia. 1999 Aug;42(8):936-43
pubmed: 10491753
N Engl J Med. 2012 Mar 8;366(10):914-24
pubmed: 22397653
Lancet. 2015 Aug 29;386(9996):913-27
pubmed: 26004339
J Clin Endocrinol Metab. 1996 Jul;81(7):2621-6
pubmed: 8675587
Endokrynol Pol. 2022;73(2):371-374
pubmed: 35381096