Table 6. Effect of therapy for hypercortisolism on glucose metabolism.
| Study, year | Patients, n | Etiology of hypercortisolism, n | Prevalence of DM and IGT at baseline, n (%) | Therapy | Duration of follow up after therapy, mean, month | Prevalence of DM and IGT at follow up, n (%) | Resolution or improvement of DM and IGT at follow up |
|---|---|---|---|---|---|---|---|
| Etxabe et al., 1994 (87) | 49 | CD: 49 | DM: 19/49 (38%) | Transsphenoidal surgery: 28 | 76.1 | DM: 9/49 (18%) | Not reported |
| IGT: 12/49 (24%) | Bilateral adrenalectomy: 18 | IGT: 2/49 (4%) | |||||
| Pituitary radiotherapy: 16 | |||||||
| Other: 1 | |||||||
| Colao et al., 1999 (86) | 15 | CD: 15 | DM: 7/15 (46.7%) | Transsphenoidal surgery: 15 | 59.9 | DM: 5/15 (33%) | Not reported |
| IGT: 6/15 (40%) | IGT: 4/15 (27%) | ||||||
| Faggiano et al., 2003 (56) | 25 | CD: 25 | DM: 5/25 (20%) | Transsphenoidal surgery: 25 | 12 | Not reported | DM resolution: 2/5 (40%) |
| IGT: 16/25 (64%) | |||||||
| Chow et al., 2008 (48) | 68 | CD: 42 | DM: 10/42 (24%) | Bilateral adrenalectomy: 68 | Not reported | Not reported | DM resolution: 2/5 (29%) |
| Ectopic CS: 26 | DM: 10/26 (38%) | ||||||
| Sippel et al., 2008 (72) | 60 | CD: 17 | DM: 24/59 (41%) | Unilateral adrenalectomy: 31 | 44.4 | Not reported | DM resolution: 15/19 (79%) |
| Adrenal CS: 33 | Reported for entire cohort | Bilateral adrenalectomy: 27 | |||||
| Ectopic CS: 10 | Missing data in 1 subject | ||||||
| Giordano et al., 2011 (27) | 29 | CD: 14 | DM: 5/14 (36%) | Transsphenoidal surgery: 14 | 12 | DM: 2/14 (14%) | Not reported |
| IGT: 2/14 (14%) | IGT: 2/14 (14%) | ||||||
| Adrenal CS: 15 | DM: 2/15 (13%) | Laparoscopic surgical | 12 | DM: 0/15 (0%) | Not reported | ||
| IGT: 6/15 (40%) | Resection: 15 | IGT: 1/15 (7%) | |||||
| Ntali et al., 2013 (74) | 311 | CD: 311 | DM or IGT: 67/311 (22%) | Surgery: 308 Medical therapy: 3 |
108 | DM/IGT: 53/311 (17%) | Not reported |
| Terzolo et al., 2014 (28) | 51 | CD:33 | DM: 14/51 (27%) | Transsphenoidal surgery: 33 | 56.55 | DM: 5/51 (10%) | Not reported |
| Radiotherapy: 2 | |||||||
| Medical therapy: 2 | |||||||
| Bilateral adrenalectomy: 8 | |||||||
| (Some patients received more than 1 treatment) | |||||||
| Adrenal CS: 15 | Unilateral adrenalectomy: 11 | ||||||
| Bilateral adrenalectomy: 4 | |||||||
| Ectopic CS: 3 | Surgical resection: 3 | ||||||
| Bancos et al., 2016 (57) | 584 | Adrenal MACS: 584 | DM: pooled proportion 52% | Adrenalectomy: 132 | At least 6 months | Not reported | DM improvement: pooled 52% |
Selection criteria: publication year: 1994 or after; design: retrospective, prospective studies or systematic reviews; intervention: surgical or medical therapy; outcome: glucose abnormality prevalence data available at baseline and/or after treatment. DM, diabetes mellitus; IGT, impaired glucose tolerance; CS, Cushing syndrome; CD, Cushing disease; MACS, mild autonomous cortisol secretion.