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Articles Published Processes
9/4/2026 5:57:40 AM | Browse: 0 | Download: 0
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Received |
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2026-06-15 01:28 |
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Peer-Review Started |
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2026-06-16 00:06 |
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First Decision by Editorial Office Director |
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Return for Revision |
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2026-07-03 09:34 |
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Revised |
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2026-07-06 16:10 |
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Publication Fee Transferred |
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Second Decision by Editor |
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2026-07-17 02:38 |
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Second Decision by Editor-in-Chief |
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Final Decision by Editorial Office Director |
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2026-07-17 08:24 |
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Articles in Press |
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2026-07-17 08:24 |
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Edit the Manuscript by Language Editor |
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2026-07-21 16:18 |
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Typeset the Manuscript |
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2026-08-14 00:36 |
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Publish the Manuscript Online |
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2026-09-04 05:57 |
| ISSN |
1948-9358 (online) |
| Open Access |
This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license. No commercial re-use. See Permissions. Published by Baishideng Publishing Group Inc. |
| Copyright |
©Author(s) (or their employer(s)) 2026. No commercial re-use. See Permissions. Published by Baishideng Publishing Group Inc. |
| Article Reprints |
For details, please visit: http://www.wjgnet.com/bpg/gerinfo/247
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| Permissions |
For details, please visit: http://www.wjgnet.com/bpg/gerinfo/207
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| Publisher |
Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA |
| Website |
http://www.wjgnet.com |
| Category |
Endocrinology & Metabolism |
| Manuscript Type |
Correspondence |
| Article Title |
Letter to the Editor: Hypothalamic-pituitary-adrenal axis dysregulation as a plausible contributor to glycated hemoglobin variability and cardiovascular risk in diabetes mellitus
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| Manuscript Source |
Unsolicited Manuscript |
| All Author List |
Ioannis Ilias and Lina Zabuliene |
| ORCID |
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| Funding Agency and Grant Number |
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| Corresponding Author |
Ioannis Ilias, Director, MD, PhD, Department of Endocrinology, Hippocration General Hospital, No. 63 Evrou Street, Athens GR-11521, Greece. iiliasmd@yahoo.com |
| Key Words |
Glycated hemoglobin; HbA1c variability; Hypothalamic-pituitary-adrenal axis; Cortisol; Cardiovascular risk; Diabetes mellitus; Adrenal incidentaloma |
| Core Tip |
The inter-visit variability of glycated hemoglobin (HbA1c) independently predicts cardiovascular outcomes in diabetes mellitus, yet its mechanistic determinants remain incompletely characterized. We propose that hypothalamic–pituitary–adrenal (HPA) axis dysregulation is a plausible, underrecognized contributor, operating through two tiers. One tier involves sustained cortisol excess-as seen in mild autonomous cortisol secretion from adrenal incidentalomas or in subclinical Cushing’s syndrome, which shifts mean HbA1c measurably across consecutive visits. The second tier involves hyperglycemia-driven HPA hyperactivity, mediated by pro-inflammatory cytokines, which perpetuates a feed-forward glycemic loop. Unexplained inter-visit HbA1c variability, after exclusion of common causes, may warrant targeted HPA axis evaluation in selected patients. |
| Publish Date |
2026-09-04 05:57 |
| Citation |
Ilias I, Zabuliene L. Letter to the Editor: Hypothalamic-pituitary-adrenal axis dysregulation as a plausible contributor to glycated hemoglobin variability and cardiovascular risk in diabetes mellitus. World J Diabetes 2026; 17(9): 124386
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| URL |
https://www.wjgnet.com/1948-9358/full/v17/i9/124386.htm |
| DOI |
https://doi.org/10.4239/wjd.124386 |
Copyright © 1993-2026 Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA. All rights reserved, including rights relating to text and data mining, AI training, and similar technologies. For open-access content, the applicable copyright and licensing terms govern.
