New Link Found Between Cortisol Levels and Stubborn Diabetes, Hypertension

New research has highlighted a strong link between hypercortisolism and two common but hard-to-treat conditions: resistant hypertension and type 2 diabetes. Studies from the CATALYST and MOMENTUM trials show that over a third of patients with both conditions had elevated cortisol levels. These findings suggest that screening for hypercortisolism could play a key role in managing patients who struggle to respond to standard treatments.

Corcept Therapeutics, a company focused on cortisol-modulating drugs, has presented data showing that its medication Korlym may offer additional benefits when combined with existing diabetes treatments. The results have sparked discussions about broader testing and new approaches to care.

The CATALYST trial examined patients with difficult-to-control type 2 diabetes. It found that 24% had hypercortisolism—a condition where the body produces too much cortisol. For those with both resistant hypertension and type 2 diabetes, the numbers were even higher: 36.6% in CATALYST and 32.6% in the MOMENTUM trial. The MOMENTUM study also revealed that 27.3% of patients with resistant hypertension alone had elevated cortisol.

When patients in the CATALYST trial took Korlym alongside GLP-1 receptor agonists or tirzepatide, they saw greater improvements than those on placebo. Their HbA1c levels dropped by a statistically significant 1.3%, while body weight fell by 5.1 kg, BMI by 1.7 kg/m², and waist circumference by 5.1 cm. These reductions were both clinically meaningful and consistent across multiple measures. Experts are now calling for wider screening. Lance Sloan, President of the Texas Institute for Kidney and Endocrine Disorders, stressed that identifying hypercortisolism should become routine for diabetes patients not responding to standard care. Bill Guyer, Chief Development Officer at Corcept, echoed this view, hoping the findings will lead to better detection and treatment options. Corcept Therapeutics specialises in drugs that modulate cortisol, targeting severe metabolic, endocrine, and neurological disorders. The company’s work suggests that cortisol-directed therapies could become a valuable addition to existing diabetes management strategies.

The trials indicate that hypercortisolism is far more common in patients with resistant hypertension and poorly controlled type 2 diabetes than previously recognised. Korlym, when added to GLP-1 or tirzepatide treatments, has shown measurable benefits in lowering blood sugar, weight, and waist size. With experts advocating for increased screening, these findings may change how clinicians approach patients who fail to improve on standard therapies.