Effect of Insulin Sensitizers in Three Patients With ACTH-Dependent Hypercortisolism

Abstract

Three women 40, 67, and 50 years old had ACTH-dependent hypercortisolism (ADH), 2/3s with diabetes (DM). Metformin alone, or in combination with the PPAR-? agonist, pioglitazone, normalized UFC in our patients and lowered plasma ACTH. With insulin sensitizer (IS) treatment, all patients experienced a decrease in UFC from baseline ? 90 %. Plasma ACTH also fell from baseline 15-20 % in all patients. Our findings suggest that ADH may be an expression of insulin resistance or that insulin resistance exerts a permissive effect on the expression of ADH in some patients. Insulin sensitizers (IS) may be an alternative treatment for some ADH patients.




J Med Cases. 2013;4(4):254-258
doi: https://doi.org/10.4021/jmc1061w