Is It Cushing's Syndrome? A Patient's Journey with Uncontrolled Diabetes Caused by Hypercortisolism
Taking Control Of Your Diabetes® - The Podcast!Show Notes
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 **Tune in for two new episodes each month! Like what you hear and want to help us grow? Please rate and review this podcast so we can reach more people living with diabetes!**
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What if you could take your basal insulin once a week instead of every day? Once-weekly basal insulin has arrived, offering a new approach that could make insulin therapy simpler while providing glucose control comparable to daily basal insulin. In this episode, Dr. Steve Edelman is joined by Dr. Athena Philis-Tsimikas, a leading diabetes researcher who has been directly involved in clinical trials of once-weekly basal insulins. Together, they explain how these ultra-long-acting insulins work, how a single injection can provide steady background insulin throughout an entire week, and what studies have shown when once-weekly insulin is compared with traditional daily basal insulin. The conversation gets practical with how once-weekly insulin is started, adjusted, and switched from daily basal insulin. Dr. Edelman and Dr. Philis-Tsimikas discuss the dosage differences with once-weekly basal insulin, how concentrated insulin keeps the actual injection volume small, and how fasting glucose can help guide dose adjustments. They also discuss what happens if you miss a dose and why reaching a steady state is an important part of understanding how these longer-acting insulins work. They also dive into the clinical trial results, including A1C, time in range, and hypoglycemia. In studies of people living with type 2 diabetes, once-weekly basal insulin provided similar A1C lowering to daily basal insulin without an increase in hypoglycemia. They also explain why the story is different for people living with type 1 diabetes, where studies found higher rates of hypoglycemia with weekly basal insulin, and what that means for its use in the United States. Finally, Dr. Edelman and Dr. Philis-Tsimikas look at how once-weekly insulin could make diabetes management easier. Going from seven basal injections a week to just one could help reduce some of the daily burden of diabetes and make it easier to consistently take your insulin. They also explore using weekly insulin alongside GLP-1 medications, potential combination therapies, cost and access, and what we still need to learn as these newer insulins move from clinical trials into everyday diabetes care. Key Topics: How once-weekly basal insulin works Once-weekly vs. daily basal insulin Starting, dosing, and adjusting weekly insulin Why weekly insulin doses may look surprisingly large A1C, time in range, and hypoglycemia results What to do if you miss a weekly dose Once-weekly insulin in type 1 vs. type 2 diabetes Who may benefit from once-weekly insulin? Reducing the burden of daily injections Using once-weekly insulin with GLP-1 medications Future insulin and GLP-1 combination therapies Cost, access, and real-world considerations What the future of basal insulin could look like This episode was supported by Lilly. ✨ Subscribe for practical diabetes management tips, technology updates, and treatment breakthroughs that help people with diabetes live healthier, more flexible lives.
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