Which of the following is NOT typically associated with persistent hyperglycemia?

• A. DM
• B. Cushing's syndrome
• C. Hyperthyroidism
• D. Hypothyroidism

Answer: (D)

Persistent hyperglycemia happens when hormones or conditions push the body toward higher glucose production or reduced glucose uptake. Diabetes mellitus is the classic cause, with impaired insulin secretion or action leading to chronically high blood sugar. Cushing's syndrome raises glucose levels by increasing gluconeogenesis and causing insulin resistance due to excess cortisol. Hyperthyroidism also tends to raise blood glucose because thyroid hormone boosts hepatic glucose production and intestinal glucose absorption, and can worsen glycemic control in people with glucose intolerance. Hypothyroidism, in contrast, slows metabolism and does not typically drive persistent high glucose levels; its effect on glucose tends to be neutral or even toward lower glucose production. So the status not usually linked with persistent hyperglycemia is hypothyroidism.