Background: Pasireotide treatment is strictly associated with glucose metabolism impairment. The aim of the study was to evaluate the effect of pasireotide on β -cell and adipose function in patients with Cushing's disease (CD).

Methods: Clinical and hormonal parameters, insulin secretion, evaluated by homostasis model assessment (HOMA-β) and by the area under the curve (AUC2h) of C-peptide during a mixed meal tolerance test and insulin sensitivity, evaluated by the euglycemic hyperinsulinemic clamp, were evaluated in 12 patients with active CD before and after 12 months of pasireotide.

Circulating adipokines were evaluated in patients with CD compared to a matched group of 12 diabetic patients.

Inclusion Criteria:

• patients with active Cushing's disease.

Exclusion Criteria:

• pituitary radiotherapy treatment performed less than 5 years before pasireotide,
• pregnancy,
• women taking oral contraceptives,
• diabetes on GLP-1 analogues,
• DPP4 inhibitors or sulphonylureas treatment,
• intolerance to SSA,
• risk conditions for prolonged QT syndrome and severe liver o renal insufficiency.