From J D Faccinetti – PWN co-founder and chief editor – Hypercortisolism, also known as Cushing’s syndrome – not to be confused with Cushing’s disease (more on that below), is far more common in people with resistant hypertension and high blood sugar than previously recognized. Recent studies have revealed a much stronger link between elevated cortisol and both type-2 diabetes and difficult-to-control high blood pressure. The significance of this is hard to overstate: hypercortisolism was recently added to the updated 2026 AACE guidelines for managing type 2 diabetes in adults, raising the question of how many patients are living with the condition unscreened.
At the American Association of Clinical Endocrinologists, AACE 2026 annual conference last week in Las Vegas, Corcept Therapeutics presented new data from two important studies.
MOMENTUM Trial — Oral Presentation “Co-secretion of Cortisol and Aldosterone in Individuals With Resistant Hypertension: Results From the MOMENTUM Trial”. The MOMENTUM trial is the largest study to date examining how common hypercortisolism is among people with resistant hypertension. The headline finding, first presented at ACC in March: 27.3% of the 1,086 patients screened — nearly 1 in 4 — had hypercortisolism. The new analysis presented at AACE examined primary aldosteronism, another condition that can drive resistant hypertension, finding it may be present in roughly 18% of the same group. The implication is that both conditions may co-occur and that screening for one should prompt screening for the other. If you’d like to learn more this is link to the presentation.
GRACE Study — Poster “Relacorilant Treatment Improves Glycemic Control Among Individuals with Endogenous Hypercortisolism and Hyperglycemia on GLP-1 Receptor Agonists: Insights from a Phase 3 Study”. This poster focused on patients with hypercortisolism and elevated blood sugar who were already taking GLP-1 medications such as semaglutide. Adding relacorilant produced nearly a 1% drop in HbA1c, along with meaningful reductions in weight and waist circumference — while preserving lean muscle mass. The finding suggests that treating excess cortisol offers benefits that GLP-1 therapy alone cannot. The broader GRACE study also met its primary endpoint of blood pressure control. Here’s a link to the poster.
About Hypercortisolism
Hypercortisolism results from too much cortisol activity in the body. It affects virtually every organ system and can be fatal if left untreated. Common symptoms include high blood pressure, abdominal weight gain, elevated blood sugar, severe fatigue, muscle weakness, and mood or cognitive changes. Cardiovascular disease is the leading cause of death. Recent research confirms the condition is more prevalent than previously thought.
Cushing’s Syndrome vs. Cushing’s Disease — What’s the Difference?
Cushing’s syndrome is the umbrella term for any condition caused by prolonged exposure to excess cortisol, regardless of the source. That source may be a tumor in the body, or it may be external. This medication-induced form is called exogenous Cushing’s syndrome and is actually the most common overall.
Cushing’s disease is a specific type of Cushing’s syndrome. It occurs when a benign pituitary tumor (adenoma) produces too much ACTH, which in turn signals the adrenal glands to overproduce cortisol. It is the most common cause of endogenous (internally produced) hypercortisolism.
Note for the Editor: There is an ongoing effort to define the nomenclature of these diseases. The current nomenclature, we believe, is most likely confusing to the general public. The distinction matters because the cause determines the treatment. Accurate diagnosis is essential and we welcome the efforts to clarify or rename the different conditions now referred as Cushing’s.
Two excellent examples are available on Pituitary World News and Adrenal World News in our videos section. Click on the links below to watch.
Pituitary Grand Rounds, episode 2: a delayed diagnosis of Cushing’s disease
Pituitary Grand Rounds, episode 3: disorders of cortisol secretion related to adrenal conditions
Image by Darwin Laganzon from Pixabay
© 2026, J D Faccinetti. All rights reserved.