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Indicators that Cushing's syndrome might be the cause of diabetes include that the insulin dose is exceeding 1 to 1.5 units/kg, clinical signs such as PU/PD and polyphagia have persisted despite decent control of blood sugar, and physical examination findings are more specific to Cushing's syndrome such as comedones, thinning hair, and secondary infections [eg, urinary tract infection and pyoderma], Kvitko-White states

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The main pathophysiological pathways concern an impairment in synaptic plasticity, deregulated dopaminergic and GABAergic neurons, abnormal mTOR signaling in the cerebellum, abnormal cell contact signaling and excitation/inhibition imbalance (Su et al., 2011)