Is it elevated cortisol or high blood sugar that damages nerves? Or both? I know that elevated cortisol levels mimic diabetes and also causes diabetes. But there are various causes for some of the same complications and symptoms. I am experiencing a lot of discomfort due to various issues. I wonder which are caused by Cushing's Disease and what is strictly related to diabetes.

Dr. David Erani


Diabetic neuropathy is damage to nerves caused by high blood glucose levels over time. Elevated levels of cortisol or similar steroids can cause blood glucose levels to be high -- sometimes very high. Cushing’s syndrome is the term for the excess steroid state. Cushing’s disease is a more specific term for the situation in which the pituitary gland produces the hormone ACTH in excess, and this leads to production of excessive levels of cortisol by the adrenal glands. Cushing’s syndrome can be caused by steroid medications such as prednisone and solumedrol. Doctors are careful not to use more of these medications than necessary. At the same time, it is very important never to stop one of these medications on your own, as they can temporarily shut down cortisol production by the adrenal glands. In this case, stopping the steroid medication could be fatal. The diagnosis of Cushing’s syndrome can be tricky. I would not assume that you have it unless it was diagnosed by your doctor.

October 29, 2012 at 4:46 pm

1 reply

LTennion 2012-11-06 20:00:23 -0600 Report

Thank you for your response to my inquiry. I was diagnosed with a Pituitary Tumor in 2011. I had my 1st Transshenoidal Surgery in April, 2011. I had my 2nd Transshenoidal Surgery in Dec, 2011. My tumor had invaded my cavernous sinus cavity and wrapped around my carotid artery. I'm currently taking Korlym. I'm trying to determine if I'm experiencing withdrawal symptoms (recovery stage) or just the side effects of medication.