Exp Clin Endocrinol Diabetes 2011; 119(9): 573-575
DOI: 10.1055/s-0031-1275288
Short Communication

© J. A. Barth Verlag in Georg Thieme Verlag KG Stuttgart · New York

Flattened Circadian Cortisol Rhythm in Type 2 Diabetes

F. Lederbogen1 , J. Hummel1 , 4 , C. Fademrecht1 , B. Krumm1 , C. Kühner1 , M. Deuschle1 , K.-H. Ladwig2 , C. Meisinger2 , H.-E. Wichmann2 , 3 , H. Lutz4 , B. Breivogel4
  • 1Central Institute of Mental Health, Mannheim, Germany
  • 2Helmholtz Zentrum München, German Research Center for Environmental Health, Institute of Epidemiology, Neuherberg, Germany
  • 3Institute of Medical Informatics, Biometry and Epidemiology, Chair of Epidemiology, Ludwig-Maximilians-Universität, Munich, and Klinikum Grosshadern, Munich, Germany
  • 4Department of General and Family Medicine, Faculty of Medicine Mannheim, Theodor Kutzer Ufer, Mannheim, Germany
Further Information

Publication History

received 27.01.2011 first decision 04.03.2011

accepted 07.03.2011

Publication Date:
06 April 2011 (online)


Introduction: While altered cortisol concentrations have been observed in subjects with type 2 diabetes their circadian cortisol profile is unknown.

Patients and methods: Using a cross-sectional design, we studied 63 ambulatory individuals with type 2 diabetes and 916 non-diabetic control subjects of the Cooperative Research in the Region of Augsburg (KORA)-F3 study. Circadian cortisol profiles were derived from saliva cortisol concentrations, determined on a regular weekday upon wake-up (F0), as well as œ h (Fœ), 8 (F8) and 14 h (F14) after wake-up.

Results: Diabetic subjects exhibited a flattened circadian cortisol profile (rm-ANOVA: F[3,654]=3.41, p=0.02), with lower morning and higher afternoon and evening cortisol concentrations.

Conclusion: We observed a flattened circadian cortisol rhythm in subjects with type 2 diabetes, providing evidence for a specific HPA system dysfunction.



F. LederbogenMD 

Central Institute of Mental


J5 68159 Mannheim


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Email: florian.lederbogen@zi-mannheim.de