{"id":"https://openalex.org/W4410156070","doi":"https://doi.org/10.2337/figshare.28640534","title":"Prevalence of Hypercortisolism in Difficult-to-Control Type 2 Diabetes","display_name":"Prevalence of Hypercortisolism in Difficult-to-Control Type 2 Diabetes","publication_year":2025,"publication_date":"2025-04-18","ids":{"openalex":"https://openalex.org/W4410156070","doi":"https://doi.org/10.2337/figshare.28640534"},"language":"en","primary_location":{"id":"doi:10.2337/figshare.28640534","doi":"https://doi.org/10.2337/figshare.28640534","is_oa":true,"landing_page_url":"https://doi.org/10.2337/figshare.28640534","pdf_url":null,"source":null,"license":"cc-by-nc-sa","license_id":"https://openalex.org/licenses/cc-by-nc-sa","version":"acceptedVersion","is_accepted":true,"is_published":false,"raw_source_name":"American Diabetes Association","raw_type":"posted-content"},"volume":null,"type":"other","indexed_in":["crossref"],"open_access":{"is_oa":true,"oa_status":"gold","oa_url":"https://doi.org/10.2337/figshare.28640534","any_repository_has_fulltext":null},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5040182038","display_name":"John B. Buse","orcid":"https://orcid.org/0000-0002-9723-3876","observed_orcids":["https://orcid.org/0000-0002-9723-3876","https://orcid.org/0000-0001-6894-4110"]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"John B Buse","raw_affiliation_strings":[],"raw_orcid":null,"affiliations":[]},{"author_position":"middle","author":{"id":"https://openalex.org/A5066700951","display_name":"Steven E. Kahn","orcid":"https://orcid.org/0000-0001-7307-9002","observed_orcids":["https://orcid.org/0000-0001-7307-9002"]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Steven E. Kahn","raw_affiliation_strings":[],"raw_orcid":null,"affiliations":[]},{"author_position":"middle","author":{"id":"https://openalex.org/A5005405894","display_name":"Vanita R. Aroda","orcid":"https://orcid.org/0000-0002-7706-4585","observed_orcids":["https://orcid.org/0000-0002-7706-4585"]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Vanita R. Aroda","raw_affiliation_strings":[],"raw_orcid":null,"affiliations":[]},{"author_position":"middle","author":{"id":"https://openalex.org/A5055037280","display_name":"Richard Joseph Auchus","orcid":"https://orcid.org/0000-0001-6815-6181","observed_orcids":["https://orcid.org/0000-0001-6815-6181"]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Richard J. Auchus","raw_affiliation_strings":[],"raw_orcid":null,"affiliations":[]},{"author_position":"middle","author":{"id":"https://openalex.org/A5054058644","display_name":"Timothy Silleck Bailey","orcid":"https://orcid.org/0000-0003-4178-3462","observed_orcids":["https://orcid.org/0000-0003-4178-3462"]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Timothy Bailey","raw_affiliation_strings":[],"raw_orcid":null,"affiliations":[]},{"author_position":"middle","author":{"id":"https://openalex.org/A5034012396","display_name":"Irina Bancos","orcid":"https://orcid.org/0000-0001-9332-2524","observed_orcids":["https://orcid.org/0000-0001-9332-2524"]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Irina Bancos","raw_affiliation_strings":[],"raw_orcid":null,"affiliations":[]},{"author_position":"middle","author":{"id":"https://openalex.org/A5103165011","display_name":"Robert S. Busch","orcid":"https://orcid.org/0000-0002-7172-2815","observed_orcids":["https://orcid.org/0000-0002-7172-2815"]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Robert S. Busch","raw_affiliation_strings":[],"raw_orcid":null,"affiliations":[]},{"author_position":"middle","author":{"id":"https://openalex.org/A5066180898","display_name":"Elena A. Christofides","orcid":"https://orcid.org/0000-0002-1595-9906","observed_orcids":["https://orcid.org/0000-0002-1595-9906"]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Elena A. Christofides","raw_affiliation_strings":[],"raw_orcid":null,"affiliations":[]},{"author_position":"middle","author":{"id":"https://openalex.org/A5073917506","display_name":"Ralph Anthony DeFronzo","orcid":"https://orcid.org/0000-0002-8581-6273","observed_orcids":["https://orcid.org/0000-0002-8581-6273"]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Ralph A. DeFronzo","raw_affiliation_strings":[],"raw_orcid":null,"affiliations":[]},{"author_position":"middle","author":{"id":"https://openalex.org/A5081614166","display_name":"Bradley Eilerman","orcid":"https://orcid.org/0000-0003-3962-3136","observed_orcids":["https://orcid.org/0000-0003-3962-3136"]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Bradley Eilerman","raw_affiliation_strings":[],"raw_orcid":null,"affiliations":[]},{"author_position":"middle","author":{"id":"https://openalex.org/A5086644070","display_name":"James W. Findling","orcid":"https://orcid.org/0000-0003-3101-5320","observed_orcids":["https://orcid.org/0000-0003-3101-5320"]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"James W. Findling","raw_affiliation_strings":[],"raw_orcid":null,"affiliations":[]},{"author_position":"middle","author":{"id":"https://openalex.org/A5034671525","display_name":"Vivian Andrew Fonseca","orcid":"https://orcid.org/0000-0002-3381-7151","observed_orcids":["https://orcid.org/0000-0002-3381-7151"]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Vivian Fonseca","raw_affiliation_strings":[],"raw_orcid":null,"affiliations":[]},{"author_position":"middle","author":{"id":"https://openalex.org/A5036768419","display_name":"Oksana Hamidi","orcid":"https://orcid.org/0000-0002-7367-3885","observed_orcids":["https://orcid.org/0000-0002-7367-3885"]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Oksana Hamidi","raw_affiliation_strings":[],"raw_orcid":null,"affiliations":[]},{"author_position":"middle","author":{"id":"https://openalex.org/A5037652425","display_name":"Yehuda Handelsman","orcid":"https://orcid.org/0000-0001-7830-0247","observed_orcids":["https://orcid.org/0000-0001-7830-0247"]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Yehuda Handelsman","raw_affiliation_strings":[],"raw_orcid":null,"affiliations":[]},{"author_position":"middle","author":{"id":"https://openalex.org/A5113419301","display_name":"Harold J. Miller","orcid":null,"observed_orcids":[]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Harold J. Miller","raw_affiliation_strings":[],"raw_orcid":null,"affiliations":[]},{"author_position":"middle","author":{"id":"https://openalex.org/A5011988555","display_name":"Jonathan G. Ownby","orcid":null,"observed_orcids":[]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Jonathan G. Ownby","raw_affiliation_strings":[],"raw_orcid":null,"affiliations":[]},{"author_position":"middle","author":{"id":"https://openalex.org/A5059717477","display_name":"John C. Parker","orcid":"https://orcid.org/0000-0003-0428-2706","observed_orcids":["https://orcid.org/0000-0003-0428-2706"]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"John C. Parker","raw_affiliation_strings":[],"raw_orcid":null,"affiliations":[]},{"author_position":"middle","author":{"id":"https://openalex.org/A5085399860","display_name":"Athena Philis\u2010Tsimikas","orcid":"https://orcid.org/0000-0002-3986-9630","observed_orcids":["https://orcid.org/0000-0002-3986-9630"]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Athena Philis-Tsimikas","raw_affiliation_strings":[],"raw_orcid":null,"affiliations":[]},{"author_position":"middle","author":{"id":"https://openalex.org/A5059098934","display_name":"Richard E. Pratley","orcid":"https://orcid.org/0000-0002-2912-1389","observed_orcids":["https://orcid.org/0000-0002-2912-1389"]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Richard Pratley","raw_affiliation_strings":[],"raw_orcid":null,"affiliations":[]},{"author_position":"middle","author":{"id":"https://openalex.org/A5045489578","display_name":"Julio Rosenstock","orcid":"https://orcid.org/0000-0001-8324-3275","observed_orcids":["https://orcid.org/0000-0001-8324-3275"]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Julio Rosenstock","raw_affiliation_strings":[],"raw_orcid":null,"affiliations":[]},{"author_position":"middle","author":{"id":"https://openalex.org/A5028308806","display_name":"Michael Howard Shanik","orcid":null,"observed_orcids":[]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Michael H. Shanik","raw_affiliation_strings":[],"raw_orcid":null,"affiliations":[]},{"author_position":"middle","author":{"id":"https://openalex.org/A5024425127","display_name":"Lance Alan Sloan","orcid":"https://orcid.org/0000-0001-7362-4410","observed_orcids":["https://orcid.org/0000-0001-7362-4410"]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Lance Alan Sloan","raw_affiliation_strings":[],"raw_orcid":null,"affiliations":[]},{"author_position":"middle","author":{"id":"https://openalex.org/A5061058170","display_name":"Guillermo E. Umpierrez","orcid":"https://orcid.org/0000-0002-3252-5026","observed_orcids":["https://orcid.org/0000-0002-3252-5026"]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Guillermo Umpierrez","raw_affiliation_strings":[],"raw_orcid":null,"affiliations":[]},{"author_position":"middle","author":{"id":"https://openalex.org/A5048191133","display_name":"Iulia Cristina Tudor","orcid":"https://orcid.org/0000-0002-4229-2940","observed_orcids":["https://orcid.org/0000-0002-4229-2940"]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Iulia Cristina Tudor","raw_affiliation_strings":[],"raw_orcid":null,"affiliations":[]},{"author_position":"middle","author":{"id":"https://openalex.org/A5114711401","display_name":"Tina K. Schlafly","orcid":"https://orcid.org/0009-0006-7769-3046","observed_orcids":["https://orcid.org/0009-0006-7769-3046"]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Tina K. Schlafly","raw_affiliation_strings":[],"raw_orcid":null,"affiliations":[]},{"author_position":"last","author":{"id":"https://openalex.org/A5112247083","display_name":"DANIEL F. EINHORN","orcid":"https://orcid.org/0000-0002-7846-9146","observed_orcids":["https://orcid.org/0000-0002-7846-9146"]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Daniel Einhorn","raw_affiliation_strings":[],"raw_orcid":null,"affiliations":[]}],"institutions":[],"countries_distinct_count":0,"institutions_distinct_count":0,"corresponding_author_ids":[],"corresponding_institution_ids":[],"apc_list":null,"apc_paid":null,"fwci":null,"has_fulltext":false,"cited_by_count":0,"citation_normalized_percentile":null,"cited_by_percentile_year":null,"biblio":{"volume":null,"issue":null,"first_page":null,"last_page":null},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T12421","display_name":"Adrenal Hormones and Disorders","score":0.8960000276565552,"subfield":{"id":"https://openalex.org/subfields/2712","display_name":"Endocrinology, Diabetes and Metabolism"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},"topics":[{"id":"https://openalex.org/T12421","display_name":"Adrenal Hormones and Disorders","score":0.8960000276565552,"subfield":{"id":"https://openalex.org/subfields/2712","display_name":"Endocrinology, Diabetes and Metabolism"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T11839","display_name":"Hormonal Regulation and Hypertension","score":0.015599999576807022,"subfield":{"id":"https://openalex.org/subfields/2712","display_name":"Endocrinology, Diabetes and Metabolism"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T10832","display_name":"Pituitary Gland Disorders and Treatments","score":0.01209999993443489,"subfield":{"id":"https://openalex.org/subfields/2712","display_name":"Endocrinology, Diabetes and Metabolism"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/hypercortisolism","display_name":"hypercortisolism","score":0.9879999756813049},{"id":"https://openalex.org/keywords/type-2-diabetes","display_name":"type 2 diabetes","score":0.972000002861023},{"id":"https://openalex.org/keywords/inadequate-glycemic-control","display_name":"inadequate glycemic control","score":0.7300000190734863},{"id":"https://openalex.org/keywords/dexamethasone-suppression-test","display_name":"dexamethasone suppression test","score":0.9750000238418579},{"id":"https://openalex.org/keywords/cortisol","display_name":"cortisol","score":0.38199999928474426},{"id":"https://openalex.org/keywords/sglt2-inhibitors","display_name":"SGLT2 inhibitors","score":0.8849999904632568},{"id":"https://openalex.org/keywords/glp-1-receptor-agonists","display_name":"GLP-1 receptor agonists","score":0.9980000257492065},{"id":"https://openalex.org/keywords/tirzepatide","display_name":"tirzepatide","score":0.984000027179718},{"id":"https://openalex.org/keywords/blood-pressure-medication","display_name":"blood pressure medication","score":0.9319999814033508},{"id":"https://openalex.org/keywords/hyperglycemia","display_name":"hyperglycemia","score":0.6679999828338623},{"id":"https://openalex.org/keywords/risk-factors","display_name":"risk factors","score":0.5870000123977661},{"id":"https://openalex.org/keywords/prevalence","display_name":"prevalence","score":0.7210000157356262},{"id":"https://openalex.org/keywords/heart-disease","display_name":"heart disease","score":0.32899999618530273},{"id":"https://openalex.org/keywords/obesity","display_name":"obesity","score":0.4480000138282776},{"id":"https://openalex.org/keywords/ethnicity","display_name":"ethnicity","score":0.8809999823570251},{"id":"https://openalex.org/keywords/fibrates","display_name":"fibrates","score":0.8889999985694885},{"id":"https://openalex.org/keywords/analgesics","display_name":"analgesics","score":0.9779999852180481}],"concepts":[{"id":"https://openalex.org/C2777180221","wikidata":"https://www.wikidata.org/wiki/Q3025883","display_name":"Type 2 diabetes","level":3,"score":0.597917914390564},{"id":"https://openalex.org/C71924100","wikidata":"https://www.wikidata.org/wiki/Q11190","display_name":"Medicine","level":0,"score":0.5769572854042053},{"id":"https://openalex.org/C555293320","wikidata":"https://www.wikidata.org/wiki/Q12206","display_name":"Diabetes mellitus","level":2,"score":0.5292705297470093},{"id":"https://openalex.org/C2775924081","wikidata":"https://www.wikidata.org/wiki/Q55608371","display_name":"Control (management)","level":2,"score":0.47112107276916504},{"id":"https://openalex.org/C126322002","wikidata":"https://www.wikidata.org/wiki/Q11180","display_name":"Internal medicine","level":1,"score":0.4635689854621887},{"id":"https://openalex.org/C134018914","wikidata":"https://www.wikidata.org/wiki/Q162606","display_name":"Endocrinology","level":1,"score":0.3680538237094879},{"id":"https://openalex.org/C41008148","wikidata":"https://www.wikidata.org/wiki/Q21198","display_name":"Computer science","level":0,"score":0.17786511778831482},{"id":"https://openalex.org/C154945302","wikidata":"https://www.wikidata.org/wiki/Q11660","display_name":"Artificial intelligence","level":1,"score":0.09174206852912903}],"mesh":[],"locations_count":1,"locations":[{"id":"doi:10.2337/figshare.28640534","doi":"https://doi.org/10.2337/figshare.28640534","is_oa":true,"landing_page_url":"https://doi.org/10.2337/figshare.28640534","pdf_url":null,"source":null,"license":"cc-by-nc-sa","license_id":"https://openalex.org/licenses/cc-by-nc-sa","version":"acceptedVersion","is_accepted":true,"is_published":false,"raw_source_name":"American Diabetes Association","raw_type":"posted-content"}],"best_oa_location":{"id":"doi:10.2337/figshare.28640534","doi":"https://doi.org/10.2337/figshare.28640534","is_oa":true,"landing_page_url":"https://doi.org/10.2337/figshare.28640534","pdf_url":null,"source":null,"license":"cc-by-nc-sa","license_id":"https://openalex.org/licenses/cc-by-nc-sa","version":"acceptedVersion","is_accepted":true,"is_published":false,"raw_source_name":"American Diabetes Association","raw_type":"posted-content"},"sustainable_development_goals":[{"display_name":"Good health and well-being","id":"https://metadata.un.org/sdg/3","score":1.0}],"study_designs":[],"awards":[],"funders":[],"has_content":{"grobid_xml":false,"pdf":false},"content_urls":null,"referenced_works_count":0,"referenced_works":[],"related_works":["https://openalex.org/W2903813785","https://openalex.org/W4414256400","https://openalex.org/W4410939759","https://openalex.org/W7202382465","https://openalex.org/W4410939790","https://openalex.org/W4389469295","https://openalex.org/W4400725727","https://openalex.org/W2467934997","https://openalex.org/W4416194141","https://openalex.org/W4409965452"],"abstract_inverted_index":{"Objective:":[0],"Despite":[1],"the":[2,28,88],"use":[3,212],"of":[4,11,30,90,114,166,171,191,213,238],"multiple":[5,64,107,245],"glucose-lowering":[6,55],"medications,":[7],"a":[8,32,71,188],"significant":[9],"fraction":[10],"individuals":[12,239],"with":[13,46,57,70,102,116,147,168,223,232,240],"type":[14],"2":[15],"diabetes":[16],"(T2D)":[17],"do":[18],"not":[19],"meet":[20],"glycemic":[21],"targets.":[22],"This":[23],"prospective,":[24],"observational":[25],"study":[26],"assessed":[27,105],"prevalence":[29,89,142,225],"hypercortisolism,":[31,91],"potential":[33],"contributing":[34],"factor":[35],"to":[36,139],"inadequate":[37],"glucose":[38],"control":[39],"(NCT05772169).":[40],"Research":[41],"Design":[42],"and":[43,48,112,118,150],"Methods:":[44],"Individuals":[45],"T2D":[47,243],"HbA1c":[49],"7.5\u201311.5%":[50],"(58\u2013102":[51],"mmol/mol)":[52],"on":[53],"\u22652":[54],"medications":[56,67,194],"or":[58,62,187,217],"without":[59],"micro-/macrovascular":[60],"complications":[61],"taking":[63,154],"blood":[65,156,192],"pressure-lowering":[66,157,193],"were":[68,82,104,122,162,221],"screened":[69],"1-mg":[72],"dexamethasone":[73],"suppression":[74],"test":[75],"(DST).":[76],"Common":[77],"causes":[78],"for":[79],"false-positive":[80],"DSTs":[81],"excluded.":[83],"The":[84,110],"primary":[85],"endpoint":[86],"was":[87,128,143,230],"defined":[92],"as":[93],"post-DST":[94],"cortisol":[95,127],">1.8":[96],"\u03bcg/dL":[97],"(50":[98],"nmol/L).":[99],"Characteristics":[100],"associated":[101,222,231],"hypercortisolism":[103,117],"using":[106],"logistic":[108],"regression.":[109],"percentage":[111],"characteristics":[113],"participants":[115,132,146,167],"adrenal":[119],"imaging":[120,160],"abnormalities":[121,161],"also":[123],"assessed.":[124],"Results:":[125],"Post-DST":[126],"unsuppressed":[129],"in":[130,145,152,164,234],"252/1057":[131],"(prevalence":[133],"23.8%;":[134],"95%":[135],"confidence":[136],"interval,":[137],"21.3":[138],"26.5).":[140],"Hypercortisolism":[141,229],"33.3%":[144],"cardiac":[148],"disorders":[149],"36.6%":[151],"those":[153],"\u22653":[155],"medications.":[158,246],"Adrenal":[159],"reported":[163],"34.7%":[165],"hypercortisolism.":[169],"Use":[170],"SGLT2":[172],"inhibitors":[173],"(odds":[174],"ratio":[175],"[OR],":[176],"1.558),":[177],"maximum-dose":[178],"GLP-1":[179],"receptor":[180],"agonists":[181],"(OR,":[182,185,195,199,206,210,215,219],"1.544),":[183],"tirzepatide":[184],"1.981),":[186],"higher":[189,224],"number":[190],"1.390),":[196],"older":[197],"age":[198],"1.316),":[200],"body":[201],"mass":[202],"index":[203],"<30":[204],"kg/m2":[205],"1.639),":[207],"non-Latino/Hispanic":[208],"ethnicity":[209],"3.718),":[211],"fibrates":[214],"2.676)":[216],"analgesics":[218],"1.457)":[220],"(all":[226],"P<0.03).":[227],"Conclusions:":[228],"hyperglycemia":[233],"approximately":[235],"one":[236],"quarter":[237],"inadequately":[241],"controlled":[242],"despite":[244]},"counts_by_year":[],"updated_date":"2026-10-27T15:51:10.671819","created_date":"2025-05-08T00:00:00"}
