Adrenal Gland Tumors May Be Misdiagnosed, Increasing Diabetes Risk: Study

Far more people have adrenal gland tumors which could increase the risk of diabetes than previously believed, researchers found.

One in 10 Americans have non-cancerous tumors on their adrenal glands, which usually pose no threat of cancer, but may lead to health side effects like high blood pressure, diabetes and other complications, according to the findings of a new study, which raises concerns about risks associated with failure to diagnosis the tumors.

The non-cancerous adrenal tumors affect millions of people, and researchers have thought these tumors have little impact on an individual’s health. However, according to a report published this month in the Annals of Internal Medicine, the tumors may lead to an underlying hormone problem, which can increase the risk of type 2 diabetes and high blood pressure.

Researchers from the United Kingdom concluded the benign tumors on the adrenal glands cause the production of excess amounts of cortisol. Roughly half of the people with adrenal tumors produce enough cortisol to increase their risk of suffering from diabetes and high blood pressure, according to the findings, leading researchers to recommend screening guidelines that will reduce the risk of misdiagnosis.

The study involved data on 1,300 people with benign adrenal tumors from 14 endocrine care centers. Nearly half of the patients with tumors had cortisol secretions, also known as mild-autonomous cortisol secretion, while 5% of patients had Cushing syndrome.

People with benign adrenal tumors and mild-autonomous cortisol secretion are more likely to be diagnosed with high blood pressure. They also face twice the risk of needing three or more blood pressure medications. These patients are also more likely to have type 2 diabetes and are twice as likely to need insulin to manage their blood sugar.

The adrenal glands produce the hormone adrenaline, as well as other hormones like cortisol, which is responsible for our “fight-or-flight” response to danger or bodily threat. But when cortisol is secreted, it can lead to increases in blood sugar levels and cause blood pressure to increase, putting patients at risk.

Other studies have found that roughly one in three adrenal tumors lead to excess secretions of cortisol. This new study indicates the number of people affected by increased levels of cortisol may be much higher. Roughly half of patients with the tumors had excess levels of cortisol and 15% had levels high enough to affect their health.

These tumors are often found while imaging scans of the abdomen are done to detect other illnesses. Roughly 70% of patients with mild-autonomous cortisol secretion are women, most were of postmenopausal age.

As a result of the findings, researchers recommend screening guidelines be changed so those with adrenal tumors are regularly screened. Anyone who has a benign adrenal tumor larger than 1 cm should be screened to determine if the tumor is secreting excess cortisol and if it affects their health in some way.