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Background
My name is Glenn Kardel. I have polyglandular autoimmune syndrome type II, frequently referred to as
Schmidt's syndrome. The classic manifestations of this syndrome
are adrenal insufficiency plus autoimmune thyroid disease and/or insulin
dependent diabetes mellitus. I have all three of the above
conditions: Addison's
disease, hypothyroidism, and type I diabetes.
Addisons and hypothyroidism are treated with oral
hormone replacement medications. Type I diabetes is the most
serious and difficult to control of the three conditions.
Treatment usually involves balancing insulin therapy administered
through injections or a pump, diet, and exercise with the goal of
maintaining normal blood sugar levels.
Having Addison's disease in conjunction with type I diabetes presents a
significant additional challenge to maintaining normal blood sugar
levels. The adrenal gland plays an important role in controlling blood
sugar. It produces a glucocorticoid hormone,
cortisol, that causes the liver to release internal stores of glucose
and reduce glucose uptake in peripheral cells when blood sugars drop
below normal levels. The goal is to counteract
the drop in blood sugar. Addison's patients usually take steroids
(hydrocortisone, prednisone) to replace the cortisol that's not produced by their
adrenal gland. These steroids have a side effect
of increasing blood sugar and also don't perfectly mimic the natural
action and production cycle of cortisol. The net effect of all of this is that
type I diabetics with Addison's disease will experience more variable and
extreme blood sugar levels. The patient who isn't prepared to
handle these changes in their diabetes will face a very risky situation.
After I was diagnosed with Addisons and started taking hydrocortisone, I
started to have highly variable blood sugars. I began to have sugars in the 300's and also
frequent hypoglycemic episodes. I started searching for information about the interaction between Addisons and
diabetes or any special treatment strategies related to the two
conditions and was surprised to find almost nothing.
Given the adverse and potentially dangerous effect Addisons has on
diabetes, this information should be explicitly stated and available to
people with Addisons and diabetes. This website is my attempt to
provide information on this subject and hopefully connect with others
who have useful information about Addisons and diabetes.
Goals
The goals of this site are:
- Provide information about Addison's disease, type I diabetes, and the interaction between
the two conditions.
- Share the techniques I've used to control my
diabetes in the face of the added pressure of Addisons.
- Provide an
opportunity
for others to share information,
experiences, and advice on Addison's disease and diabetes.
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