My Story

Forum for Addisons and diabetes related issues.

My Story

Postby captex » Mon May 21, 2012 1:26 pm

This isn't my whole story, just the part that's of concern to me right now as we speak.

My Rheumy discovered and confirmed that I have developed Addison's. My concern is that from a Diabetes perspective. My numbers don't go down, they go up. And now that I'm on Prednisone, they go even higher. I'm on Glipizide, Glucophage, Levemir AND Novalog. If I attempt to eat anything other than a Low Carb diet, I get numbers that jumt to the 300's with me taking all my meds.

I thought that LOW were the issue with Addisons's. Am I wrong?
captex
 
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Re: My Story

Postby SueM » Mon May 28, 2012 11:41 pm

captex wrote:This isn't my whole story, just the part that's of concern to me right now as we speak.

My Rheumy discovered and confirmed that I have developed Addison's. My concern is that from a Diabetes perspective. My numbers don't go down, they go up. And now that I'm on Prednisone, they go even higher. I'm on Glipizide, Glucophage, Levemir AND Novalog. If I attempt to eat anything other than a Low Carb diet, I get numbers that jumt to the 300's with me taking all my meds.

I thought that LOW were the issue with Addisons's. Am I wrong?


You need to do some basal testing and sort that out then adjust your bolus insulin (carb ratio) I'm not sure if you are type 1 or 2 due to your medication mix.
Have you not been shown how to adjust your own insulin? If I was showing numbers like yours I sure would be doing something about it.
If you haven't been shown how to adjust yourself then ask to be shown and also invest in a couple of books. Think like a pancreas and using insulin. Both can be found on amazon.

You also say you have been put on Pred what dose have you been put on?

Low blood sugars with Addison's will only happen if you are under medicated. If on the right dose then once you have your basal sorted then you shouldn't have a problem diabetes wise.
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Re: My Story

Postby captex » Tue May 29, 2012 9:59 am

Thanks for the reponse Sue. I'm a Type II Diabetic. I take 500mg of Glucophage ER twice daily, 10mg of Glipizede twice daily, 25 units of Levemir in the AM and Novalog on a sliding scale that starts at 2 units at a BG reading of 150.

I don't get below 140 at all anymore. As I said, this is with virtually no carbs whatsoever. If I eat as the Heart Health Diet suggest, I will have numbers in the 220 - 275 range.

My number continued to spiral upwards as Addison's Developed.

Did I read your comments correctly, that you assume that once I start to "control" Addison's my lows with Diabetes will most likely become a problem.
captex
 
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Re: My Story

Postby SueM » Wed May 30, 2012 12:31 am

captex wrote:Thanks for the reponse Sue. I'm a Type II Diabetic. I take 500mg of Glucophage ER twice daily, 10mg of Glipizede twice daily, 25 units of Levemir in the AM and Novalog on a sliding scale that starts at 2 units at a BG reading of 150.

I don't get below 140 at all anymore. As I said, this is with virtually no carbs whatsoever. If I eat as the Heart Health Diet suggest, I will have numbers in the 220 - 275 range.

My number continued to spiral upwards as Addison's Developed.

Did I read your comments correctly, that you assume that once I start to "control" Addison's my lows with Diabetes will most likely become a problem.


If you are a low carber to you eat a lot of fat and protien? If so perhaps cut back on them as I have found the more fat and protien eaten the higher my insulin requirement. In fact I tend to need a lot more insulin if I have a high fat or protien meal :(

I'm curious to know how you were diagnosed with Addison's as the norm is low blood sugars at and before diagnoses.
No hypo's are not a problem anymore than usual with the diabetes/Addison's mix.
From reading your posts I do get the impression that your medical team haven't educated you in managing your insulin requirements. You need to learn to carb count and adjust your insulin as needed. The way you are doing things is very dated and not very good. Many people also find that Levemir does not last the 24 hours, so worth looking into splitting your dose with advice from your Dr, obviously.
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Re: My Story

Postby captex » Wed May 30, 2012 2:40 pm

Sue,

On a hunch, my Rheumatologist did the ACTH Stimulation Test and there was no response from my Adrenals. My morning Cortisol was 1.2. This was while I was taking 10mg of Prednisone. She had all the other Labs from the Hospital that indicated the possibility of Adrenal Insufficency. Low Blood Pressure (50/30 & 70/30) before IV's were started on two different ER Visits. A Massive RA Flare where all my joint became inflammed. Orthostatic Hypotension. There's was alot more, the point is that the indicators showed AI. Unfortunately, the ER Drs. never checked for it. They simply treated the symptoms. My Rheumatologist is the person that figured it out.

I did asked about my spike in my BG Level and she pointed out that with all my other issues, and they are considerable. That Addison's is still is the most likely cause, but that it would be up to the Endocrinologist to sort it out. She put me on 5mg of Prednisone twice daily and the symptoms subsided signicicantly. My cause is either RA damage to the Adrenals or Long Term use of Prednisone to treat Interstitial Lung Disease. I was on Prednisone for 3 1/2 years.

Either way, my Adrenals do not produce sufficient Natural Steroids to supply my body with it's daily needs. In fact, I missed a morning dose two days ago, and I thought that I would have to go back to the ER. I felt so bad.

I just noticed today that the board is dedicated to Addison's and Type I Diabetics. So if I have overstayed my welcome, I do apologize.
captex
 
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Re: My Story

Postby SueM » Thu May 31, 2012 9:45 am

captex wrote:Sue,

On a hunch, my Rheumatologist did the ACTH Stimulation Test and there was no response from my Adrenals. My morning Cortisol was 1.2. This was while I was taking 10mg of Prednisone. She had all the other Labs from the Hospital that indicated the possibility of Adrenal Insufficency. Low Blood Pressure (50/30 & 70/30) before IV's were started on two different ER Visits. A Massive RA Flare where all my joint became inflammed. Orthostatic Hypotension. There's was alot more, the point is that the indicators showed AI. Unfortunately, the ER Drs. never checked for it. They simply treated the symptoms. My Rheumatologist is the person that figured it out.

I did asked about my spike in my BG Level and she pointed out that with all my other issues, and they are considerable. That Addison's is still is the most likely cause, but that it would be up to the Endocrinologist to sort it out. She put me on 5mg of Prednisone twice daily and the symptoms subsided signicicantly. My cause is either RA damage to the Adrenals or Long Term use of Prednisone to treat Interstitial Lung Disease. I was on Prednisone for 3 1/2 years.

Either way, my Adrenals do not produce sufficient Natural Steroids to supply my body with it's daily needs. In fact, I missed a morning dose two days ago, and I thought that I would have to go back to the ER. I felt so bad.

I just noticed today that the board is dedicated to Addison's and Type I Diabetics. So if I have overstayed my welcome, I do apologize.

Hi Captex,
there are many that post here who do not have diabetes, and everyone is welcome. :)
As to your steroid dose all I can say is flipping heck, that is almost double the normal amount of steroids for anyone to take.
If I were you I would be looking for a new team of Drs very quickly. The dosing routine is very bad as well.

You really need to get yourself sorted diabetes wise and learn how to manage your diabetes and how to regulate your insulin correctly. It's no wonder your blood sugar is so high with that massive dose of steroids. To much steroid is just as bad as not enough.
SueM
 
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Re: My Story

Postby captex » Fri Jun 01, 2012 5:57 am

Sue, I inadvertantly missed one morning dose and the consequences were quite severe. I didn't go to the ER. But I did feel just awful. It has taken days to recover from it.

I did see a Endocrinologist yesterday and he ordered a bunch of labwork that I did this morning and said to me to wait about a week for the results. It's going to be a very long week!

Thanks for the Welcome to stay.
captex
 
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Re: My Story

Postby gkardel » Sat Jun 09, 2012 10:20 pm

Captex,

On a hunch, my Rheumatologist did the ACTH Stimulation Test and there was no response from my Adrenals. My morning Cortisol was 1.2. This was while I was taking 10mg of Prednisone. She had all the other Labs from the Hospital that indicated the possibility of Adrenal Insufficency.


The prednisone you were taking prior to your ACTH stim test invalidated the results. If you want a valid test you'll need to get off prednisone and replace with dexamethasone. Your endo should definitely pick this up. Have your ACTH level tested prior to the stim test. You need to get this test done properly.

Prednisone has a strong glucocorticoid component which can cause big problems with blood sugar. The higher the dose, the bigger the risk for problems with blood sugar and other side effects. Prednisone therapy can cause type 2 diabetes, osteoporosis, and secondary adrenal insufficiency.

-Glenn
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