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This study aimed to explore whether changes in CGM-derived glycaemic metrics could be observed during timed evening metyrapone administration in patients with MACS.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This prospective, single-centre interventional study included nine patients with MACS due to adrenal adenoma or hyperplasia and coexisting prediabetes or untreated mild type 2 diabetes. Participants underwent continuous glucose monitoring (CGM) for one week at baseline and for one week during treatment with the 11\u03b2-hydroxylase inhibitor metyrapone (500\u00a0mg at 6:00 PM and 250\u00a0mg at 10:00 PM). Morning (8:00 AM) serum cortisol, ACTH levels and parameters of glucose metabolism were assessed. Data distribution was evaluated using the Shapiro\u2013Wilk test; paired comparisons were performed using appropriate parametric or non-parametric tests, with correction for multiple comparisons.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>After one week of metyrapone treatment, the percentage of time with glucose levels between 70 and 140 mg\/dL (time-in-tight-range, TITR) increased from 81% to 84% (p\u2009&lt;\u20090.05). Time in range (70\u2013180 mg\/dL) increased from 98.4% to 99.4%, while time above range (&gt;\u2009180 mg\/dL) decreased from 1.4% to 0.1% (both p\u2009&lt;\u20090.05). ACTH concentrations increased, while morning cortisol levels remained stable.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>After short-term evening administration of metyrapone a modest yet statistically significant change in CGM-derived glycaemic metrics was observed in patients with MACS, without altering morning cortisol levels. These findings support the need for further studies to evaluate the long-term metabolic effects of adrenostatic therapy in this population.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s12020-026-04601-y","type":"journal-article","created":{"date-parts":[[2026,5,2]],"date-time":"2026-05-02T02:27:21Z","timestamp":1777688841000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Effects of short-term metyrapone treatment on glycaemic control in patients with mild autonomous cortisol secretion: a pilot study"],"prefix":"10.1007","volume":"91","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4769-0729","authenticated-orcid":false,"given":"Alessandro","family":"Rossini","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Silvia","family":"Pellegrini","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2982-3153","authenticated-orcid":false,"given":"Silvia","family":"Ippolito","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara","family":"Cassibba","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luca","family":"Giovanelli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Margherita","family":"Zappoli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8610-4772","authenticated-orcid":false,"given":"Roberto","family":"Trevisan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2990-8181","authenticated-orcid":false,"given":"Giuseppe","family":"Lepore","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,5,2]]},"reference":[{"issue":"1","key":"4601_CR1","doi-asserted-by":"publisher","first-page":"G1","DOI":"10.1093\/ejendo\/lvad066","volume":"189","author":"M Fassnacht","year":"2023","unstructured":"M. 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