dc.contributor.author |
Karuppiah, D. |
en_US |
dc.contributor.author |
Cooray, M.S.A. |
en_US |
dc.contributor.author |
Somasundaram, N. |
en_US |
dc.contributor.author |
Ediriweera, D.S. |
en_US |
dc.date.accessioned |
2018-03-07T09:37:58Z |
en_US |
dc.date.available |
2018-03-07T09:37:58Z |
en_US |
dc.date.issued |
2018 |
en_US |
dc.identifier.citation |
International Journal of Advanced Research. 2018; 6(1) : 603-610 |
en_US |
dc.identifier.issn |
2320-5407 |
en_US |
dc.identifier.uri |
http://repository.kln.ac.lk/handle/123456789/18623 |
en_US |
dc.description |
Not Index |
en_US |
dc.description.abstract |
INTRODUCTION: Cushing’s syndrome (CS) may be unrecognized in patients with diabetes. There is no consensus on routine screening for CS in patients with type 2 diabetes (T2DM). Aim of the study was to evaluate the prevalence of unsuspected CS in out-patients with diabetes. METHODS: Cross sectional prospective study was conducted at diabetes clinic in National Hospital of Sri Lanka among patients with diabetes who were attending for out-patient visit from January-2016 to January- 2017. Total of 287 patients were investigated with over-night dexamethasone- suppression test (ODST) as a screening test. Patients who fail to suppress serum cortisol less than 50nmol/l were further tested by Low-dose-dexamethasone-suppression test (LDDST). A third step midnight cortisol measurement was performed in patients who were failed to suppress cortisol less than 50nmol/l on LDDST. Fourth step imaging studies with pituitary MRI, abdominal-CT or CT-scan of chest abdomen and pelvis depending on the ACTH levels were performed. RESULTS: Out of 287, 46.18% (133) patients failed to suppress cortisol to less than 50nmol/l on ODST. Among these 133, 23(11.49% of total) patients failed to suppress cortisol less than 50nmol/l on LDDST. Nine out of 23 patients had cortisol more than 140nmol/l on midnight cortisol test, confirming true CS. Further investigations with imaging revealed one with pituitary adenoma, one with adrenal adenoma and 6 had normal imaging. CONCLUSION: Considering the prevalence of definitive CS of 3.18% among poorly controlled T2DM patients with hypertension and obesity suggest that CS is not rare as previously thought. But in our Asian population with T2DM and high prevalence of co-morbidities, taking overnight dexamethasone suppression test alone as a screening test would not be a suitable test to screen CS. |
en_US |
dc.language.iso |
en_US |
en_US |
dc.subject |
Cushing Syndrome |
en_US |
dc.subject.mesh |
Hypertension |
en_US |
dc.subject.mesh |
Diabetes Mellitus, Type 2 |
en_US |
dc.subject.mesh |
Obesity |
en_US |
dc.subject.mesh |
Mass Screening |
en_US |
dc.subject.mesh |
Cross-Sectional Studies |
en_US |
dc.subject.mesh |
Prospective Studies |
en_US |
dc.title |
Screening of cushings syndrome in patients with poorly controlled type 2 diabetes with hypertension and obesity |
en_US |
dc.type |
Article |
en_US |