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

Alan Sacerdote, Gul Bahtiyar, MaryAnn Banerji, Geeti Mahajan, Marie-Alex Michel Vincent, Richard Vincent


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


ACTH-dependent; Hypercortisolism; Insulin resistance; Insulin sensitizer; Metformin; Thiazolidinediones

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