Stronger association between morning serum cortisol level and diurnal time in range in type 2 diabetes?

Abstract

Abstract Background The hypothalamic-pituitary-adrenal axis is thought to play a vital role in glucose homeostasis and diabetes. This study investigated the association between morning serum cortisol and time in range (TIR), including daytime TIR, in type 2 diabetes (T2DM). Methods 310 patients with T2DM had serum cortisol measured at 8 a.m. All participants underwent continuous glucose monitoring (CGM) for three consecutive days, then TIR and glycemic variability (GV) parameters were evaluated. Using 100 g standard steamed bread meal test, blood glucose, C peptide and insulin at different points were collected to assess insulin sensitivity and islet function. Results Patients with higher serum cortisol exhibited lower TIR and TITR (P 0.05). Multiple stepwise regression revealed that cortisol was an independent contributor of TIR, TITR and diurnal TIR, with diurnal TIR of stronger relevance. Conclusions Morning serum cortisol is negatively correlated with TIR, especially diurnal TIR and positively associated with GV parameters. Inappropriate cortisol secretion may have an adverse influence on glucose homeostasis in T2DM.

Keywords

• Cortisol
• The HPA axis
• Continuous glucose monitoring
• Time in range
• Diurnal time in range
• Type 2 diabetes mellitus