Is It Cushing's Syndrome? A Patient's Journey with Uncontrolled Diabetes Caused by Hypercortisolism

The diagnosis of Cushing's Syndrome is often missed because its underlying cause, hypercortisolism, masks itself as 'just diabetes,' 'just stress,' or 'just getting older,' which can lead to serious problems. In this conversation, Dr. Steve Edelman talks with a military veteran named Phil and his wife Cherese about years of unexplained fatigue, tough-to-control blood sugars, and high blood pressure, and the one test that made everything make sense. This episode discusses the early warning signs, how to advocate for answers and the hypercortisolism treatments that helped Phil feel like himself again. You’ll also hear why targeted hypercortisolism treatments and diabetes-specific approvals are on their way.

You’ll learn why hypercortisolism is more common than most people realize, how it can hide behind type 2 diabetes, and what tests and treatments can make a life-changing difference.

• Why hypercortisolism is so often overlooked: Symptoms overlap with diabetes, stress, and other common health issues.
• Phil’s story of resilience: From managing diabetes with multiple medications to discovering hypercortisolism as the root cause.
• The partner’s perspective: How Cherese noticed the warning signs and pushed for further testing.
• The Catalyst Study: Why research shows up to 1 in 4 people with hard-to-control type 2 diabetes may have hypercortisolism.
• Diagnosis explained: The 1 mg overnight dexamethasone suppression test and why it matters.
• Treatment and transformation: How targeted therapies improved Phil’s blood sugars, energy, sleep, and overall quality of life.
• Key takeaways: Be your own best advocate—if your numbers don’t add up, it’s worth asking why.

Timecodes:
0:00 – What is Cushing's Syndrome (hypercortisolism) & guest setup

0:41 – Steroids & cortisol 101: why persistently high cortisol wreaks havoc

2:01 – Phil’s backstory: diabetes diagnosis and years of “uncontrolled” numbers

4:55 – Escalating meds, rising A1C, growing fatigue—when things stop making sense

7:25 – Cherese’s Story: lifestyle overhaul, then deeper testing when sugars don’t improve

10:47 – Classic signs of Cushing's Syndrome (buffalo hump, thin arms) & sleep issues

11:23 – CATALYST study: up to 1 in 4 with tough-to-control T2D show evidence of hypercortisolism

13:10 – Diagnosing Cushing's: The hypercortisolism suppression test

16:06 – Treatment wins: targeted therapy improves glucose, mood, sleep; “new era” in care

20:45 – Takeaways: Recognizing Cushing's, self-advocacy & red flags

Important Links:
Cortisol in Control website:
https://www.cortisolincontrol.com/
https://www.cortisolmatters.com/patient

Visit TCOYD's Website for more diabetes edutainment for people living with diabetes: tcoyd.org

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