Cushing's Syndrome surgical outcomes

Luke, I looked up Cushing's Syndrome....sounds like a bad deal.

If the girl is truly T1, then I would seriously doubt that curing the Cushion's Syndrome would
cure her diabetes. Since she has been T1 since the age of 7, I imagine that she is honestly T1. It
may, however, make her diabetes easier to control. Any other illnesses can strongly affect control
of sugars.

If the girl is not truly T1, but simply exhibits the symptoms of T1 due to the effects of Cushing's
Syndrome, then I would think that fixing the problem (Cushing's) would also fix her symptoms of T1.
I really have no idea.

I hope you will post again and let us know how it goes for her. I hope your friend will be
okay. Steph

"Luke Webber" <[email protected]> wrote in message
news:[email protected]...
> A young friend of mine, a 15YO girl, has recently been told she *might*
have
> Cushing's Syndrome, but tests won't be performed until early next year.
I've
> been looking for information on the web, but I have one important question which isn't answered
> there, hence this post.
>
> The girl in question has been suffering from Type I diabetes since the age of seven, her
> specialists have been unable to keep her sugar levels or her blood pressure under control, and
> irreversible kidney disease may be just around the corner.
>
> Now the question. If her condition *is* a result of Cushing's Syndrome, which can be cured through
> surgery, will that also "cure" her diabetes?
>
> It almost seems too much to expect, because we're conditioned to think of diabetes as an incurable
> condition, but if the diabetic symptoms turn out
to
> be the result of another, curable condition, then it seems to be implied.
>
> TIA for any contributions or suggestions.
>
> Luke

"Luke Webber" <[email protected]> wrote in message
news:[email protected]...
> A young friend of mine, a 15YO girl, has recently been told she *might*
have
> Cushing's Syndrome, but tests won't be performed until early next year.
I've
> been looking for information on the web, but I have one important question which isn't answered
> there, hence this post.
>
> The girl in question has been suffering from Type I diabetes since the age of seven, her
> specialists have been unable to keep her sugar levels or her blood pressure under control, and
> irreversible kidney disease may be just around the corner.
>
> Now the question. If her condition *is* a result of Cushing's Syndrome, which can be cured through
> surgery, will that also "cure" her diabetes?
>
> It almost seems too much to expect, because we're conditioned to think of diabetes as an incurable
> condition, but if the diabetic symptoms turn out
to
> be the result of another, curable condition, then it seems to be implied.
>
> TIA for any contributions or suggestions.

There was a woman who used to post here who was eventually diagnosed with Cushing's Syndrome. In her
case, I don't think there was an operation, but she was given steroids which would then eventually
bring on diabetes. I wasn't aware that there was a cure for Cushing's.

--
Type 2 http://users.bestweb.net/~jbove/

Luke Webber writes:

> A young friend of mine, a 15YO girl, has recently been told she *might* have Cushing's Syndrome,
> but tests won't be performed until early next year.

Cushing's syndrome, or Cushing's disease? They aren't the same thing. The former is a set of
symptoms that resembles those of the latter, and may or may not be caused by the latter. Only the
latter is ever treated with surgery (the former is treated by treating the cause of the symptoms).

> The girl in question has been suffering from Type I diabetes since the age of seven, her
> specialists have been unable to keep her sugar levels or her blood pressure under control, and
> irreversible kidney disease may be just around the corner.

Type I diabetes is caused by destruction of the beta cells in the pancreas, not by Cushing's
disease. Even if Cushing's disease is present, curing it will not cure the DM.

Cushing's disease is associated with Type II DM, which is in turn part of Cushing's syndrome.

> Now the question. If her condition *is* a result of Cushing's Syndrome, which can be cured through
> surgery, will that also "cure" her diabetes?

Not if it is Type I. If it is Type II, it may, depending on how much damage has already been done.
She's young, so if the disease is not too severe, chances would be good.

> It almost seems too much to expect, because we're conditioned to think of diabetes as an incurable
> condition ...

Type I diabetes mellitus is incurable currently, because there is no way to replace the damaged
function of the pancreas; it can only be treated by injections of insulin.

Type II DM may be cured if an underlying cause can be found and corrected. More often, it is sent
into remission by treatments such as major weight loss (obesity is the major cause of Type II DM).
The remission is pretty much the same as a cure, except that the patient will develop clinical DM
again if he gains weight or returns to the state that caused the DM the first time. Some Type II DM
can only be treated on a continuing basis with hyperglycemics or insulin, and in these cases it is
pretty much like Type I DM in its incurability, except that a few problems like DKA and other acute
manifestations are a bit less likely in Type II DM (unfortunately, long-term complications are just
as common, as they depend only on the degree of long-term hyperglycemia, not its cause).

> ... but if the diabetic symptoms turn out to be the result of another, curable condition, then it
> seems to be implied.

Diabetes mellitus is really a set of clinical abnormalities, the essence of which is chronic
hyperglycemia. The causes of Type I are very few and incurable--they amount essentially to physical
destruction of insulin-producing cells, and there is no way currently to replace those cells. The
causes of Type II are many and somewhat poorly understood; if the cause for a specific patient can
be successfully treated, then the DM itself will disappear.

In people with Cushing's disease that has not been severe enough or longstanding enough to cause
permanent damage to glucose metabolism, curing the Cushing's disease should eliminate any
concomitant DM (i.e., it will cure the diabetes as well).

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Julie Bove writes:

> There was a woman who used to post here who was eventually diagnosed with Cushing's Syndrome. In
> her case, I don't think there was an operation, but she was given steroids which would then
> eventually bring on diabetes.

Cushing's syndrome is just a set of symptoms. Curing it depends on curing whatever is causing the
symptoms. Steroids are _not_ used to cure the syndrome; it's an excess of steroids that is usually
the _cause_ of the syndrome. People who take steroids over long periods, as for allergies, may
develop Cushing's syndrome.

> I wasn't aware that there was a cure for Cushing's.

Cushing's _disease_ is one cause of Cushing's syndrome. In Cushing's disease, the adrenal glands
produce too much steroid, and this excess of steroids is what produces the symptoms of Cushing's
syndrome. One way to treat Cushing's disease is to remove part of the adrenal glands, thus reducing
their output of steroids; if this is done correctly and successfully, the disease is cured.
Sometimes the glands produce too much because of tumors (benign or malignant); removing the tumors
cures the disease.

Anything that produces an excess of steroids in the body will produce Cushing's syndrome. Steroid
administration used to treat other diseases is a very common cause of the syndrome.

The symptoms of Cushing's syndrome include chronic hyperglycemia, i.e., diabetes mellitus.
Eliminating whatever causes the symptoms will eliminate the hyperglycemia, and thus will
eliminate the DM.

--
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On Tue, 2 Dec 2003 04:09:53 UTC, Mxsmanic <[email protected]>
wrote:

> Cushing's disease is associated with Type II DM, which is in turn part of Cushing's syndrome.

Will creatin ratio abnormalities lead to diagnosing this?

"Mxsmanic" <[email protected]> wrote in message
news:[email protected]...
> Julie Bove writes:

> Cushing's syndrome is just a set of symptoms. Curing it depends on curing whatever is causing the
> symptoms. Steroids are _not_ used to cure the syndrome; it's an excess of steroids that is usually
> the _cause_ of the syndrome. People who take steroids over long periods, as for allergies, may
> develop Cushing's syndrome.
>
> > I wasn't aware that there was a cure for Cushing's.
>
> Cushing's _disease_ is one cause of Cushing's syndrome. In Cushing's disease, the adrenal glands
> produce too much steroid, and this excess of steroids is what produces the symptoms of Cushing's
> syndrome. One way to treat Cushing's disease is to remove part of the adrenal glands, thus
> reducing their output of steroids; if this is done correctly and successfully, the disease is
> cured. Sometimes the glands produce too much because of tumors (benign or malignant); removing the
> tumors cures the disease.
>
> Anything that produces an excess of steroids in the body will produce Cushing's syndrome. Steroid
> administration used to treat other diseases is a very common cause of the syndrome.
>
> The symptoms of Cushing's syndrome include chronic hyperglycemia, i.e., diabetes mellitus.
> Eliminating whatever causes the symptoms will eliminate the hyperglycemia, and thus will
> eliminate the DM.

Many thanks for a truly helpful post. It seems wierd to be *hoping* that a friend has Cushing's, but
given the alternative, it sounds like a walk in the park.

Thanks again, Luke

"Mxsmanic" <[email protected]> wrote in message
news:[email protected]...

<snip>

> Anything that produces an excess of steroids in the body will produce Cushing's syndrome. Steroid
> administration used to treat other diseases is a very common cause of the syndrome.
>
> The symptoms of Cushing's syndrome include chronic hyperglycemia, i.e., diabetes mellitus.
> Eliminating whatever causes the symptoms will eliminate the hyperglycemia, and thus will
> eliminate the DM.

Hmmm... Perhaps my memory is faulty then. I could have sworn she said she was put on steroids as a
treatment. I stand corrected.

--
Type 2 http://users.bestweb.net/~jbove/

[email protected] writes:

> Will creatin ratio abnormalities lead to diagnosing this?

I don't know. There are specific tests that can isolate Cushing's disease, but even they are subject
to some false positives, as there are a few situations in which results consistent with Cushing's
disease may appear in the absence of that disease (obesity, depression, etc.--these may be effects
or causes). Other tests may be consistent with Cushing's syndrome, but they don't necessarily
indicate the presence of the disease.

In the case of Cushing's syndrome, then, obviously it's a matter of clinical interpretation, since
it isn't a disease itself.

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"Steroid" is a general term including many different molecules which cause different effects.
....not just "steroids."

On Tue, 2 Dec 2003 21:55:37 +1000, "Luke Webber" <[email protected]> wrote:

>"Mxsmanic" <[email protected]> wrote in message
>news:[email protected]...
>> Julie Bove writes:
>
>> Cushing's syndrome is just a set of symptoms. Curing it depends on curing whatever is causing the
>> symptoms. Steroids are _not_ used to cure the syndrome; it's an excess of steroids that is
>> usually the _cause_ of the syndrome. People who take steroids over long periods, as for
>> allergies, may develop Cushing's syndrome.
>>
>> > I wasn't aware that there was a cure for Cushing's.
>>
>> Cushing's _disease_ is one cause of Cushing's syndrome. In Cushing's disease, the adrenal glands
>> produce too much steroid, and this excess of steroids is what produces the symptoms of Cushing's
>> syndrome. One way to treat Cushing's disease is to remove part of the adrenal glands, thus
>> reducing their output of steroids; if this is done correctly and successfully, the disease is
>> cured. Sometimes the glands produce too much because of tumors (benign or malignant); removing
>> the tumors cures the disease.
>>
>> Anything that produces an excess of steroids in the body will produce Cushing's syndrome. Steroid
>> administration used to treat other diseases is a very common cause of the syndrome.
>>
>> The symptoms of Cushing's syndrome include chronic hyperglycemia, i.e., diabetes mellitus.
>> Eliminating whatever causes the symptoms will eliminate the hyperglycemia, and thus will
>> eliminate the DM.
>
>Many thanks for a truly helpful post. It seems wierd to be *hoping* that a friend has Cushing's,
>but given the alternative, it sounds like a walk in the park.
>
>Thanks again, Luke

Luke Webber writes:

> Many thanks for a truly helpful post. It seems wierd to be *hoping* that a friend has Cushing's,
> but given the alternative, it sounds like a walk in the park.

When Cushing's syndrome can be easily treated, it's not much of a problem. When it cannot, it
produces a constellation of problems, and may be incompatible with life, either short-term or
(especially) long-term, depending on the severity of the syndrome. Severe, untreated Cushing's
syndrome is like having ten diseases at once, any one of which is likely to end life early.

It's really nothing more than the problems you get with long-term administration of steroids. This
is why steroids are usually used with great care and only for short periods.

Incidentally, severe cases of Cushing's syndrome can be very readily recognized by simply looking at
the patient. Search the Web for images to see a few striking examples. However, the syndrome can
present with a complete range of severities, from subclinical (it may never be recognized or may
never merit any special treatment) to life-threatening.

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Looking around, I see that Cushing's disease is usually due to microtumors in the pituitary, much
more often than neoplasms in the adrenals themselves. Sorry about that.

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James Michael Howard writes:

> "Steroid" is a general term including many different molecules which cause different effects.
> ....not just "steroids."

Glucocorticoids, cortisol.

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