INS and Cushing syndrome due to macronodular adrenal hyperplasia: First, excess of glucocorticoids, as seen in Cushing syndrome, have been found to inhibit insulin secretion by pancreatic β cells and reduce insulin sensitivity in liver, skeletal muscle, and adipose tissue (Mazziotti et al. 2011), as well as increase the risk of diabetes (Chiodini et al. 2005; Clore and Thurby-Hay 2009).