Episode 3: Signs and Symptoms of Excess Cortisol in the Body
A panelist discusses how screening for excess cortisol in individuals with poorly controlled type 2 diabetes can uncover a hidden hormonal driver of insulin resistance and poor glycemic control, enabling earlier intervention and more targeted, effective treatment to reduce long-term complications.
By
Pamela Kushner, MD
| Published on June 4, 2025
2 min read
The following is an AI-generated summary based on the video content above:
Screening for excess cortisol in individuals with poorly controlled type 2 diabetes is important due to the significant impact cortisol has on glucose regulation and overall metabolic health. Elevated cortisol levels can increase insulin resistance and impair glucose tolerance, which complicate diabetes management. These hormonal disruptions not only make it harder for patients to achieve stable blood sugar levels but also create added challenges for clinicians trying to tailor effective treatment strategies. Identifying cortisol imbalance early can help address a root cause of poor glycemic control rather than just treating the symptoms.
Beyond worsening insulin resistance, excess cortisol may also conceal other underlying issues contributing to unstable blood sugar. When hypercortisolism is present, patients are at an elevated risk for both macrovascular and microvascular complications. These include cardiovascular disease as well as conditions such as diabetic retinopathy, kidney disease, and peripheral neuropathy, which are all linked to prolonged periods of poor glucose control. Therefore, the presence of high cortisol levels can have a compounding effect on health outcomes in people with type 2 diabetes.
Timely screening and identification of hypercortisolism can lead to more accurate diagnoses and better-targeted treatments. Intervening early allows for proper management of cortisol levels, which can improve insulin sensitivity, enhance glycemic control, and reduce the risk of long-term complications. By distinguishing between diabetes that stems primarily from lifestyle and genetics and that which is driven or worsened by hormonal imbalances, clinicians can provide more precise care. Ultimately, incorporating cortisol screening into diabetes care protocols can be a valuable tool in improving both immediate and long-term health outcomes.
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