ECE2021 Eposter Presentations Adrenal and Cardiovascular Endocrinology (21 abstracts)
Addison’s disease and type 2 diabetes
Wajdi Safi , Dhoha Ben Salah , Sidina Mohamed Elmoctar , Mohamed Abdallahi Mohamed Ahmed , Nadia Charfi , Fatma Mnif , Nabila Rekik , Mouna Mnif , Faten Hadj Kacem & Mohamed Abid
Hedi Chaker Hospital, Endocrinology, Sfax, Tunisia
Introduction
Recent studies in patients with Addison’s disease (AD) have shown that this condition, even if treated, is fraught with significant morbidity. In this context, we report a retrospective study which concerned 32 patients with AD in order to determine the deleterious effects of long-term glucocorticoid substitution, mainly on the occurrence of type 2 diabetes.
Results
In the 32 patients followed during this study, the average fasting blood sugar level at the discovery of the disease was 4.8 mmol/l. After an average of 17 years of follow-up (range 5 and 38 years) 25% of the patients had developed type 2 diabetes. At the last consultation, almost half of the patients (42.8%) were on insulin with a dose average of 0.66 IU/kg per day. Diabetes was unbalanced in 85.7% of cases with an average fasting glucose of 9.22 mmol/l and an average HBA1c of 10.01%. The impact assessment showed retinopathy and diabetic nephropathy in 25% of patients for each.
Discussion
In the literature, a higher risk of glucose intolerance or even diabetes has been noted during treated AD. This is because patients treated with hydrocortisone have higher cortisol concentrations than physiologically, especially in the afternoon. This reduces glucose tolerance, insulin sensitivity and secretion in these patients. This effect is proportional to the dose of hydrocortisone without correlation with the duration of the disease.
Conclusion
Adjustment of replacement therapy during Addison’s disease is an issue in view of the morbidity and mortality associated with overdose. Regular monitoring and a personalized therapeutic approach are necessary to improve the prognosis of his patients.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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