New Studies Link Hypercortisolism to Worse Diabetes and Hypertension Outcomes

New research has revealed the impact of hypercortisolism on patients with type 2 diabetes and resistant hypertension. The findings were presented at the American Diabetes Association’s 86th Scientific Sessions, showcasing results from the CATALYST and MOMENTUM trials. Both studies suggest that cortisol modulation could play a key role in improving metabolic health for these high-risk groups. The CATALYST trial focused on patients with poorly controlled type 2 diabetes, where 24% were found to have hypercortisolism. Those treated with Korlym—a cortisol modulator—saw notable improvements: a 1.3% drop in HbA1c, a 5.1 kg reduction in body weight, a 1.7 kg/m² decrease in BMI, and a 5.1 cm smaller waist circumference compared to placebo. The benefits were even greater for patients also taking GLP-1 receptor agonists or tirzepatide, with reductions of 1.7% in HbA1c, 6.1 kg in weight, 2.0 kg/m² in BMI, and 6.5 cm in waist size.

The MOMENTUM trial examined patients with resistant hypertension, revealing that 27.3% had hypercortisolism. This figure rose to 36.6% in CATALYST and 32.6% in MOMENTUM when both conditions—resistant hypertension and type 2 diabetes—were present. These results highlight a strong link between elevated cortisol levels and metabolic complications.

Lance Sloan, M.D., President of the Texas Institute for Kidney and Endocrine Disorders, stressed the potential of cortisol modulation in managing difficult-to-control diabetes. Meanwhile, Bill Guyer, PharmD, Corcept’s Chief Development Officer, called for wider screening of hypercortisolism and better treatment strategies. Corcept Therapeutics, the company behind Korlym, specialises in developing therapies that target cortisol’s effects on severe metabolic and endocrine disorders. The trials demonstrate that Korlym, when combined with existing diabetes medications, can enhance metabolic outcomes for patients with hypercortisolism. The findings also underscore the importance of identifying and treating elevated cortisol levels in high-risk groups. Researchers now advocate for broader screening and tailored interventions to address this often-overlooked condition.