“When I was pregnant with my son in 1993, I developed gestational diabetes.
“After the birth, I expected my blood sugars to return to normal but they didn’t. I was diagnosed with type 2 diabetes and prescribed medication, then insulin. I also had to see an endocrinologist every three months and I regularly mentioned a problem I was concerned about: my tummy was getting bigger and
bigger. It didn’t feel like it was just fat either. The bulk was high and hard.
Are you pregnant?
“The endocrinologist said it was normal to put on weight around your middle with diabetes and suggested I exercise more. I walked regularly and ate well but my tummy kept growing.
“One day I went to see a neighbour I hadn’t seen for a few months. ‘Oh Diane, are you pregnant?’ she exclaimed. I was very hurt and told her I wasn’t but after that people kept commenting. One day a complete stranger even turned to me and said: ‘Are you pregnant, love?’
“I wore increasingly baggy clothes but people at work commented and my friends did too. ‘It’s because you have such little, skinny arms and legs,’ one explained. But by now I was in my early 50s (I’m 54 now). I tried to laugh it off. ‘I wish I was young enough to be pregnant,’ I used to say, but actually I felt like throttling them.
“On top of this I had very high blood pressure. It got so bad I was referred to a cardiologist and then was on yet another medication to bring it down.
“I don’t know how long I’d have continued like that with my tummy growing and my blood sugars and blood pressure rising, but then out of the blue one of my friends suggested: ‘Diane, why don’t you get your cortisol levels checked?’
Cortisol to blame
“Cortisol is a hormone we release when under stress. I don’t know what my friend had been reading to suggest it, but I spoke to my endocrinologist, she arranged a 24-hour urine test and, sure enough, the result was very high.
“I was then sent for a CT scan and that revealed a four-centimetre tumour on my right adrenal gland. This was causing the high production of cortisol and a condition caused Cushing’s syndrome.
“My large tummy was a typical symptom, as were the purple marks like bruises that kept appearing on the backs of my hands and my high blood pressure. It also causes blood-sugar levels to rise.
“The tumour wasn’t cancerous and I had an operation to remove both it and the adrenal gland.
“A year on, I’m off the insulin and my blood pressure medication has been cut right back. Eventually I’ll be able to come off it completely. My stomach has shrunk right back and I’ve dropped from 68 kilos to 60. I feel as if I’ve won the lottery.”
What is Cushing’s Syndrome?
Cushing’s syndrome is a condition involving too much cortisol in the body. Dr Julie Miller, a specialist endocrine surgeon in Melbourne, says there are three main causes:
1. Doctors prescribing cortisol for skin conditions, asthma or physical injuries.
2. A tumour on the pituitary, the little gland at the base of the brain, which causes the adrenal glands to make too much cortisol.
3. A tumour on an adrenal gland.
It can be difficult for doctors to diagnose but the change in body shape over a short time is a big clue.
+ A central distribution of fat and thin limbs.
+ A fat pad on the upper back.
+ Muscle weakness, especially in the upper arms and thighs.
+ The face becoming very round.
+ Pimples and, in women, hairiness on the face, while hair on the head may get thinner.
+ Purple stretch marks.
+ Easy bruising.
If a GP suspects Cushing’s, they will refer you to an endocrinologist. If a tumour is the cause, surgery is the best treatment and it usually takes a year for the body to return to normal.
Miller says it is important to seek help because as well as obesity and high blood pressure, the condition can lead to heart disease and osteoporosis.