Addison's disease

[victry77]

Hi, just got back from my annual review, saw a new doctor (very efficient) and she's sending me for blood tests for Addison's disease.

The reason being frequent hypos. Now I've been T1 for exactly two and a half years and I've had a very good honeymoon period. I was originally put on 2x day Novomix and have since stayed on it. I know it's a bit restrictive and harder to get the perfect insulin/carb balance, but TBH, it's done me fine. No major highs at all. However, I did want to mention at this appt. that I would like to start on the multi day soon as now, at this point, I don't feel I'm getting the best out of the 2xday. Control is getting a bit more wonky and yes I can tend towards quite a few hypos in the week (many of them, my own fault, I will hold my hands up)

Suddenly, the doc starts going on about Addison's & how this causes hypos and that my honeymoon period has gone on far too long.

Anyway, personally, in myself, I feel really well. I have no symptoms of anything. I've been on mission to gain a bit more weight, which I have. I feel good. I'm also starting some new, exciting college courses in September, so mentally, I've been feeling really motivated & generally feeling very optimisitc about life and my diabetes. Now... I feel a bit like ****

Thing is, whenever I do get nervous, anxious, excited, etc, my BG level always goes up. And as Addison's is to do with lack of stress hormone, wouldn't it be unlikely for it to shoot up if I had it? Here's an example,; it's now my lunch time and I would usually be around the 6 mark. Just tested and I'm 9.1. Hmm, anything to do with feeling stressed since coming back from that appointment? :evil:

 

[jopar]

Addsions doesn't increase blood glucose, due to lack of cortisone. stress hormones increase not lower bg..

It can send your blood glucose into your boots...

Some Indicators that suggest a diabetic might have addisons

Hypo's that really can't be explain, increased frquency and no percieved underlying reasons...

Also the hypo's can take a lot more fast acting carbs to stablise, along side a increase in carb intake following to prevent going into hypo again...

Other symptons of Addisons is fategue (sp), also BP will drop very dramatically prior and durning a crisis...



Diabetics who suffer with addisons find

When their addisons is stable the steroid regime has little effect on blood glucose, how ever when they start to go into crisis, the additional steroids given to restablise the addisons can have quite an impact on the blood glucose causing a two fold problem with controling/stablising the addisons and controlling an increasing blood sugar level..

I've known one diabetic, prior to being diagnoised with addisons, munching through 500g of fast acting carbs in an attempt to avoid a major hypo...

 

[victry77]

Addsions doesn't increase blood glucose, due to lack of cortisone. stress hormones increase not lower bg..

Hi, yeah, exactly, that's what I'm saying. When I get nervous, anxious, etc, my BG always goes up. Quite high on some occasions. But I always know that the increase is because my adrenaline is pumping. So what I'm meaning is, wouldn't this indicate that I have got functional adrenaline/cortisol levels otherwise I wouldn't be experiencing increased BG due to stress?

I guess I'm just wondering if the doc might have been a bit over-zealous here.

 

[jopar]

Doc may well be, but it isn’t a bad as the necessary tests to either rule this in or out as a factor in your changing control will be done sooner than later..

The changes in your control can be just your present regime not being flexible enough to allow you to find tune your control to suit your needs, going onto MDI and being taught carb counting so that you can adjust your insulin dose, also the factors that need to be taken into consideration when adjusting the dose, may be what needed..

I would also have a look at what types of carbs/meals you are eating before hypo’s as it’s possible with some carbs and meal combination that the adsorption rate means could be delayed enough to cause a hypo before they start to adsorb pizza effect..

I would also look at your BG data to see if anything jumps out, hypo’s occurring at certain times of the day or after you’ve done certain activities, remember different types of exercise can affect an individual differently, and not always at the time of the exercise or directly after...
For me an day of heavy exercise will also affect my blood sugar levels the following day..

 

[victry77]

Hi, thanks. Yeah, tbh, I more or less know the exact time when I'm likely to go hypo. I have read previously that people on 2xday can be prone to hypos. Since upping my test count from 4 to 6 per day, I've done much better in controlling the hypos. For example, mid-afternoon could always be a funny time, sometimes I would need to snack but sometimes not. So I always make sure I test to catch any hypos before they happen. Of course, if you're busy at work & what not it can be easy to forget, so this may result in a hypo. I don't really have many hypos that I can't explain.

The changes in your control can be just your present regime not being flexible enough to allow you to find tune your control to suit your needs

I do actually think this is the case, plus slowly exiting the honeymoon phase. I think if I'd have seen the top endo guy then I wouldn't be getting sent for Addison's bloodwork. As you say, nothing wrong with the doc being cautious, but I think her being new, young & possibly not very experienced (she was constantly in & out to the top guy while seeing patients) she's gone down the overly-cautious avenue (which can sometimes lead to freaking patients out unecessarily).

I just remembered, she even suggested I might be a candidate for a pump :shock: Slightly premature since I'm not even on MDI yet? :lol: