Adrenocortical insufficiency and diabetes mellitus type 1
Authors:
Kateřina Šimůnková 1,2; Karel Vondra 1
Authors‘ workplace:
Endokrinologický ústav, Praha
1; Univerzita Karlova v Praze, 1. lékařská fakulta, III. interní klinika VFN
2
Published in:
Čas. Lék. čes. 2010; 149: 120-124
Category:
Review Article
Overview
Adrenocortical disorders represents an important problem in patients with type 1 diabetes mellitus and therefore many physicians are concerned with this issue. The causes of adrenocortical insufficiency include both autoimmunity and dysregulation related to insufficiently compensated diabetes. Early diagnosis of hypocorticism remains doubtful. Diagnostic approaches are not standardized or unified and especially their evaluation and interpretation are a matter of discussion.
Treatment of proven hypocorticism, notably of the subclinical form in diabetic patients, remains questionable. Modes of substitution used presently cannot mimic fully diurnal rhythm of glucocorticoid secretion in spite of newly developed drug forms. The risk of glucocorticoid overdose persists, and insulinotherapy need to be adjusted permanently.
Key words:
Addison’s disease, adrenocortical insufficiency, diabetes mellitus type 1, low-dose ACTH test, autoantibodies against 21 hydroxylase, autoimmune hypophysitis, autoimmune polyglandular syndrome, 11ß-hydroxysteroid dehydrogenase type 1.
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Tato práce vznikla za podpory grantového projektu IGA MZ ČR NR/9154-3.
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Addictology Allergology and clinical immunology Angiology Audiology Clinical biochemistry Dermatology & STDs Paediatric gastroenterology Paediatric surgery Paediatric cardiology Paediatric neurology Paediatric ENT Paediatric psychiatry Paediatric rheumatology Diabetology Pharmacy Vascular surgery Pain management Dental HygienistArticle was published in
Journal of Czech Physicians
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