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Endocrinology Diseases

Cushing’s Syndrome

Cushing’s syndrome is a hormonal disorder characterized by abnormally high levels of cortisol in the blood. This disorder is usually caused by cortisol or adrenocorticotropic hormone (ACTH) producing tumors which can be removed surgically. Cushing’s syndrome has been observed in mammals besides humans such as dogs and horses. This should not be confused with Cushing’s disease, which refers to a specific type of non-cancerous tumor in the pituitary gland. This tumor does cause the syndrome, but is by no means the only possible cause.

There are many distinct symptoms of Cushing’s syndrome. Patients often experience significant weight gain in the trunk area without any notable growth in the extremities. Their facial profile becomes more rounded and the fat-pads across the top of the torso enlarge in irregular ways (lipodystrophy). Additionally, the capillaries dilate easily, the skin thins out, and excessive sweating occurs. The combination of these symptoms can cause a range of skin abnormalities. These symptoms are also accompanied by a slew of psychological issues that can be induced by the excess cortisol, such as euphoria and depression, as well as physiological ramifications like amenorrhea, insomnia, and impotence.

Cushing’s syndrome is generally diagnosed by a dexamethasone suppression test. This test releases a hormone that provides negative feedback on the pituitary gland in respect to cortisol, which causes normal patients to enter significantly low levels of cortisol. Cushing’s patients, however, would still display unaffected to elevated levels of cortisol. The test is usually confirmed by a CT scan of the adrenal glands and an MRI of the pituitary gland, in which they look for the growth responsible for the additional hormone production.

Many Cushing’s patients are victim to their own medicine prescribed to fight other conditions within their body. These subjects are advised to slowly diminish their dosage once the other issue has been resolved so as to ensure an agreeable return to normal endocrine activity. Sometimes patients have developed a tumor that produces ACTH or cortisol in an unrestrained manner. In this case, surgical excision is the likely course of action. There are certain drugs that inhibit cortisol synthesis, which can be utilized if the patient is unwilling or unfit for surgery, however their effectiveness is mediocre compared to surgery.


Diabetes is a serious, chronic metabolic disorder in which the body does not produce enough insulin. This condition affects an estimated 20.8 million people in the US - nearly 7 percent of the population. Diabetes is one of the leading causes of death in the US and is a growing disease. The Center for Disease Control and Prevention estimates that one in three people born in 2000 will be affected by diabetes. Although diabetes can lead to serious complications, it can often be successfully managed through dedicated, lifelong treatment.

When we eat, our body breaks down most of our food into glucose, a sugar in our blood that is the main source of energy. The glucose from food travels into the bloodstream with the help of insulin, a hormone produced by the pancreas. Our body usually produces enough insulin to move the glucose into the bloodstream, but this process does not work properly in people with diabetes. The pancreas either produces little to no insulin, or the insulin is not utilized properly. This causes a buildup of glucose that then passes out through the urine and does not fuel the body.

There are several different types of diabetes, some of which include:

  • Type 1 Diabetes is an autoimmune disease in which the body attacks itself. In this case, the body attacks the insulin-producing cells and requires people to take daily insulin injections in order to live.
  • Type 2 Diabetes is the most common form of diabetes and is affected by age, obesity and family history. Although the pancreas usually produces enough insulin, the body cannot use it effectively and production slowly decreases.
  • Prediabetes is a condition in which blood glucose levels are high but not high enough to diagnose diabetes. Prediabetes increases the risk of developing type 2 diabetes, but you can prevent or delay the diagnosis by losing weight.
  • Gestational Diabetes occurs in women during late stages of pregnancy and involves a shortage of insulin. Most cases disappear at the end of the pregnancy, but this puts women at risk for developing type 2 diabetes later on.

Diabetes is diagnosed by testing the blood glucose levels. These tests may be performed after fasting, after drinking a beverage high in glucose or randomly. If the blood glucose level is above a certain amount, depending on the conditions of the test, a diabetes diagnosis can be confirmed.

People with diabetes can manage the condition through life changes, daily insulin injections and glucose level monitoring. Eating healthy and engaging in regular physical activity helps to manage blood pressure and cholesterol levels to reduce the risk of cardiovascular disease.

People with type 1 diabetes need to take adequate insulin levels each day to balance what they eat, and must keep checking their glucose levels as well. Those with type 2 diabetes need to perform frequent blood glucose tests, and may also need insulin or oral medication.

It is important for people with diabetes to take an active role in the management of their condition. Monitoring blood glucose levels is essential in preventing episodes of hypoglycemia and hyperglycemia. Many diabetes patients work with a team of specialists to take full control of their condition.

If not treated properly, diabetes can lead to heart disease, stroke and kidney failure. It can also cause permanent eye, foot, skin and bone damage. A lifelong commitment is needed in order to prevent these complications. With practice and dedication, your daily treatment can quickly become just another part of your everyday routine.

Please visit Dr. Diez's website to learn more about diabetes.

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