November 1984

Hypothalamic-Pituitary-Adrenocortical Activity in Patients With Diabetes Mellitus

Author Affiliations

From the Department of Psychiatry (Drs Cameron and Greden) and the Mental Health Research Institute (Dr Greden), University of Michigan Medical School, Ann Arbor; the Department of Psychiatry, University of Iowa Hospitals, Iowa City (Dr Kronfol); and the Department of Psychiatry, Duke University Medical Center, Durham, NC (Dr Carroll).

Arch Gen Psychiatry. 1984;41(11):1090-1095. doi:10.1001/archpsyc.1983.01790220080013

• Several clinical and physiologic associations between depression and diabetes mellitus have been reported. In this study, a potential neuroendocrine association was studied by measuring hypothalamic-pituitary-adrenocortical (HPA) axis activity in patients with diabetes mellitus. Plasma cortisol levels and response to dexamethasone administration were determined in 54 diabetics. Twenty-three (55%) of forty-two 1-mg dexamethasone suppression tests (DSTs) performed in 34 subjects, with eight repeated tests, and two (10%) of twenty 2-mg DSTs demonstrated a blunting of normal suppression. None of a variety of potential demographic, physiologic, or mood factors predicted nonsuppression. This study replicates prior findings that HPA dysfunction occurs in association with diabetes, and invalidates the use of the 1-mg DST as a diagnostic marker for melancholia in patients with diabetes.