HELP NEEDED

Forum for Addisons and diabetes related issues.

HELP NEEDED

Postby JIMBOB48 » Sun Aug 24, 2008 8:15 pm

I AM HAVING TROUBLE CONVINCING MY ENDO AND DIABETES EDUCATOR THAT ADDISONS HAS A BIG EFFECT ON DIABETES MANAGEMENT. CAN ANYONE HELP ME WITH SPECIFICS AND REFERNCES TO REFERE TO. THANKS
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Re: HELP NEEDED

Postby gkardel » Wed Aug 27, 2008 10:50 pm

Unfortunately there's no official document or study that details all the pieces of the puzzle but if your endo can't see the whole picture, I would look for another one.

Cortisol, the hormone produced by the adrenal gland and that we replace by taking hydrocortisone or prednisone, is in a class of steroid hormones called glucocorticoids. The name alone implies that it impacts blood sugar. Cortisol is an antagonist to insulin and increases blood sugar by triggering the release of glucose through gluconeogenesis. Cortisol is not an easy hormone to replace as it has a wake sleep (diurnal) production cycle. Cortisol production ramps up from very low levels several hours before you wake up. It should be peaking around the time you wake up. It ramps down to low levels by the early evening with several smaller spikes in production on the way. Hydrocortisone and prednisone do a lousy job of mimicking this pattern and as a result we are sometimes over replaced and other times under replaced which in turn can impact our diabetes. The impact of the cortisol replacement meds on diabetes can be decreased by minimizing the dose and breaking the dose down into more frequent smaller doses. Prednisone has a stronger impact on blood sugar than hydrocortisone.

Here's some stuff to look at and show them:

Hope this helps.

Glenn
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Re: HELP NEEDED

Postby butterfly » Thu Sep 04, 2008 7:52 pm

Thanks Glenn! You're a wealth of knowledge!
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Re: HELP NEEDED

Postby wizabef » Tue Sep 09, 2008 4:53 am

Hi,
My husband has a very rare condition called APECED, as part of this condition he has Addison's and Diabetes (as well as many other things). I found this site - http://www.apeced.net - to be full of helpful information... and under the health professionals section there is information on treating people with APECED and it states "A patient who has two or all of HP[hypoparathyroidism], AF[adrenal failure] and DM[diabetes melitis], is usually complicated to treat and requires follow-up by an endocrinologist, because those diseases and their treatments influence each other". Further on (under the diabetes heading) it says "Its control, when associated with AF and HP, may be quite demanding." The direct link to the treatment PDF is http://www.apeced.net/documents/treatment.pdf. You'll just have to ignore the bits that don't apply to you :-)
I hope this helps,
Liz
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Re: HELP NEEDED

Postby JIMBOB48 » Wed Nov 05, 2008 10:22 pm

THANK YOU FOR ALL THE RESPONSES. JUST TO LET YOU ALL KNOW I HAVE AN APOINTMENT AT THE MAYO CLINIC ON THE 25TH. HOPEFULLY THEY CAN FIND THE ANSWERS TO MY QUESTIOPNS AND FATIGUE.
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