Hypothalamic-pituitary-adrenocortical activity in patients with diabetes mellitus

Arch Gen Psychiatry. 1984 Nov;41(11):1090-5. 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.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • Blood Glucose / analysis
  • Depressive Disorder / blood
  • Depressive Disorder / complications
  • Depressive Disorder / diagnosis*
  • Dexamethasone*
  • Diabetes Complications
  • Diabetes Mellitus / blood*
  • Diabetes Mellitus / physiopathology
  • Female
  • Hospitalization
  • Humans
  • Hydrocortisone / blood*
  • Hypothalamo-Hypophyseal System / physiopathology
  • Male
  • Middle Aged
  • Pituitary-Adrenal System / physiopathology


  • Blood Glucose
  • Dexamethasone
  • Hydrocortisone