In a patient with Cushing syndrome, which metabolic change would you expect?

In a patient with Cushing syndrome, which metabolic change would you expect?

• A. Hyperglycemia
• B. Hypoglycemia
• C. Normal
• D. Decreased 2-hour postprandial glucose

Answer: (A)

Excess cortisol drives glucose up by two main actions: it stimulates the liver to produce more glucose (gluconeogenesis) and it reduces how effectively insulin can lower blood glucose, causing insulin resistance. So after meals or fasting, glucose remains high. This makes hyperglycemia the expected metabolic change in Cushing syndrome. Hypoglycemia wouldn’t fit because the cortisol excess tends to raise, not lower, blood sugar. A normal level is unlikely with persistent high cortisol, and the 2-hour postprandial glucose would be elevated due to continued gluconeogenesis and impaired glucose uptake rather than decreased.

Excess cortisol drives glucose up by two main actions: it stimulates the liver to produce more glucose (gluconeogenesis) and it reduces how effectively insulin can lower blood glucose, causing insulin resistance. So after meals or fasting, glucose remains high. This makes hyperglycemia the expected metabolic change in Cushing syndrome. Hypoglycemia wouldn’t fit because the cortisol excess tends to raise, not lower, blood sugar. A normal level is unlikely with persistent high cortisol, and the 2-hour postprandial glucose would be elevated due to continued gluconeogenesis and impaired glucose uptake rather than decreased.