TOPLINE:

In patients with Cushing syndrome (CS) and concomitant type 2 diabetes (T2D) and/or obesity, GLP‑1 receptor agonists (GLP‑1 RAs) significantly reduced body weight and BMI and improved glycaemic control along with liver function.

METHODOLOGY:

• Researchers conducted a multicentre, retrospective observational study to evaluate the efficacy and safety of GLP-1 RAs in improving metabolic parameters in patients with CS and concurrent T2D and/or obesity.
• They included 20 adult patients with a confirmed diagnosis of CS (mean age, 48.7 years; 17 women) who received GLP-1 RAs (liraglutide, semaglutide, tirzepatide, or dulaglutide) for at least 3 months.
• Changes in body weight, BMI, blood pressure, fasting glucose levels, A1c levels (%), lipid parameters, and liver enzyme levels were compared before and after treatment with GLP-1 RAs.
• Safety outcomes such as treatment tolerance, adverse effects, and treatment-related complications were also assessed.
• The median treatment duration was 13 months.

TAKEAWAY:

• After treatment with GLP-1 RAs, the mean body weight reduced significantly from 98.9 to 88.5 kg (mean difference, -10.3 kg), and the mean BMI dropped from 37.1 to 32.9 (mean difference, -4.2; P < .001 for both).
• Mean fasting glucose levels decreased significantly from 124.4 to 112.3 mg/dL (mean difference, -12.1 mg/dL; P = .015), and A1c levels declined from 7.1% to 6.6% (mean difference, -0.5%; P = .011).
• Improvements in liver enzymes were observed, with a decrease in levels of alanine aminotransferase and gamma-glutamyl transferase; levels of adrenocorticotropic hormone and cortisol remained stable.
• Overall, 26.3% of patients reported adverse events, and all were mild and predominantly gastrointestinal in nature; 85% of patients showed good treatment tolerance.

IN PRACTICE:

"GLP-1RAs may be considered as adjunctive therapy for the management of obesity and dysglycemia in patients with CS, both in the setting of active disease and after biochemical control of hypercortisolism," the authors wrote.

SOURCE:

This study was led by Pedro Iglesias, Department of Endocrinology and Nutrition, Hospital Universitario Puerta de Hierro Majadahonda, Madrid, Spain. It was published online on March 10, 2026, in Endocrine.

LIMITATIONS:

The retrospective nature of the study and the small sample size may have introduced residual confounding and limited statistical power, particularly for subgroup analyses. The study population was clinically heterogeneous, which may have attenuated disease-specific metabolic effects and limited the generalisability of the findings to more homogeneous populations. Different GLP-1 RAs were used, and the treatment duration was not uniform.

DISCLOSURES:

This study did not receive any funding from any sources. The authors declared having no competing interests.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.