POMC and type 2 diabetes mellitus: Moreover, up to 25–30% of patients with AI shows autonomous cortisol secretion (ACS) [2, 3, 6, 7], defined as a low-grade ACTH independent cortisol excess that could be associated with comorbidities as arterial hypertension, type 2 diabetes mellitus (T2DM), obesity, dyslipidemia, and osteoporosis [2, 8–11].