Difficult-to-Control Type 2 Diabetes and a Post-Dexamethasone Suppression Test Cortisol of 1.2–1.8 µg/dL: Findings From a Large Prospective Study

Summary

While current guidelines recommend a post–1-mg DST cortisol cutoff of >1.8 μg/dL for hypercortisolism screening, a continuum of cardiometabolic risk appears to exist as a function of non-suppressible cortisol
Cardiac comorbidities and the use of glucose-lowering and antihypertensive medications among the participants with post-DST cortisol 1.2–1.8 μg/dL more closely resembled the subgroup with post-DST cortisol >1.8 μg/dL than the subgroup with post-DST cortisol <1.2 μg/dL
Further investigation of individuals with post-DST cortisol below 1.8 μg/dL is warranted, as they show similarities to those above the current hypercortisolism diagnostic cutoff