Table 2.
Characterization of hyperglycemia management in patients with Cushing syndrome at time of diagnosis and after remission
Variable | Total N = 174 |
Pituitary CS N = 106 |
Ectopic CS N = 25 |
Adrenal CS N = 43 |
P |
---|---|---|---|---|---|
Baseline diagnosis | |||||
Duration of hyperglycemia at time of diagnosis with CS, mo, median (range) Available for n = 164 |
16 (0-458) | 19.5 (0-249) | 1 (0-190) | 21 (0-458) | .02 |
Type of hyperglycemia, n (%) | |||||
DM2 | 139 (79.9%) | 92 (86.8%) | 17 (68%) | 30 (69.8%) | .03 |
IGT/IFG/Prediabetes | 33 (19.0%) | 13 (12.3%) | 7 (28%) | 13 (30.2%) | |
DM1 | 2 (1.1%) | 1 (0.9%) | 1 (4%) | 0 (0%) | |
Baseline HbA
1c
, %, median (ranges) Available for n = 165 |
6.9 (4.9-13.1) | 7.1 (4.9-13.1) | 6.75 (5.3-11.4) | 6.6 (5.4-11.1) | .35 |
Baseline fasting glucose, mg/dL, median (ranges) Available for n = 168 |
132 (60-427) | 135 (60-427) | 133 (90-368) | 130 (80-330) | .40 |
Baseline hyperglycemia therapy b | |||||
No therapy, n (%) | 41 (23.6%) | 17 (16.0%) | 6 (24.0%) | 18 (41.8%) | .003 |
Patients treated with oral medicationsa, n (%) No. of oral medications, n (%) |
93 (53.4%) | 66 (62.3%) | 8 (32.0%) | 19 (44.2%) | .04 |
1 | 59 (33.9%) | 39 (36.8%) | 6 (24.0%) | 14 (32.6%) | |
2 | 26 (14.9%) | 19 (17.9%) | 2 (8.0%) | 5 (11.6%) | |
3 | 8 (4.6%) | 8 (7.5%) | 0 (0%) | 0 (0%) | |
Patients treated with insulin, n (%) | 64 (36.8%) | 39 (36.8%) | 12 (48.0%) | 13 (30.2%) | .34 |
Insulin daily units, median (ranges) | 58 (10-360) | 75 (15-360) | 32.5 (12-155) | 48 (10-116) | .06 |
Hyperglycemia during postoperative period, final workup | |||||
Resolution of hyperglycemia, n (%) | 37 (21.3%) | 22 (20.8%) | 9 (36%) | 6 (14.0%) | .001 |
Improvement of hyperglycemia, n (%) | 82 (47.1%) | 60 (56.6%) | 9 (36%) | 13 (30.2%) | |
Absence of improvement of hyperglycemia, n (%) | 55 (31.6%) | 24 (22.6%) | 7 (28%) | 24 (55.8%) | |
Follow-up HbA
1c
, final workup %, median (ranges) Available for n = 130 |
6.1 (4.4-11.3) | 6.0 (4.4-10.3) | 5.9 (4.5-8.1) | 6.4 (5.2-11.3) | .20 |
Follow-up fasting glucose, final workup, mg/dL, median (ranges) Available for n = 141 |
108 (63-270) | 106 (69-224) | 97 (82-152) | 112 (63-270) | .11 |
Follow-up hyperglycemia therapy, final workup c | |||||
No therapy, n (%) | 80 (46.0%) | 43 (40.6%) | 16 (64.0%) | 21 (48.8%) | .10 |
Patients treated with oral medicationsa, n (%) No. of oral medications, n (%) |
60 (34.5%) | 42 (39.6%) | 4 (16.0%) | 14 (32.6%) | .30 |
1 | 44 (25.3%) | 30 (28.3%) | 4 (16.0%) | 10 (23.3%) | |
2 | 13 (7.5%) | 9 (8.5%) | 0 (0%) | 4 (9.3%) | |
3 | 3 (1.7%) | 3 (2.8%) | 0 (0%) | 0 (0%) | |
Patients treated with insulin, n (%) | 42 (24.1%) | 24 (22.6%) | 7 (28.0%) | 11 (25.6%) | .83 |
Insulin daily units, median (ranges) | 63 (7-236) | 73 (12-236) | 40 (7-96) | 38 (15-125) | .24 |
Abbreviations: CS, Cushing syndrome; DM, diabetes mellitus; HbA1c, glycated hemoglobin A1c; IFG, impaired fasting glucose; IGT, impaired glucose tolerance.
a Owing to small sample size, use of noninsulin injectables was not included.
b Patients treated with orals alone, n = 68, insulin alone n = 39, and both orals/insulin n = 25.
c Patients treated with orals alone, n = 44, insulin alone n = 26, both orals/insulin n = 16.