Document Detail


Nocturnal hypoglycemia identified by a continuous glucose monitoring system in patients with primary adrenal insufficiency (Addison's Disease).
MedLine Citation:
PMID:  22242902     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Hypoglycemia can be a symptom in patients with Addison's disease. The common regimen of replacement therapy with oral glucocorticoids results in unphysiological low cortisol levels in the early morning, the time of highest insulin sensitivity. Therefore patients with Addison's disease are at risk for unrecognized and potentially severe nocturnal hypoglycemia also because of a disturbed counterregulatory function. Use of a continuous glucose monitoring system (CGMS) could help to adjust hydrocortisone treatment and to avoid nocturnal hypoglycemia in these patients.
METHODS: Thirteen patients with Addison's disease were screened for hypoglycemia wearing a CGMS for 3-5 days.
RESULTS: In one patient we identified a hypoglycemic episode at 3:45 a.m. with a blood glucose level of 46 mg/dL, clearly beneath the 95% tolerance interval of minimal glucose levels between 2 and 4 a.m. (53.84 mg/dL). After the hydrocortisone replacement scheme was changed, the minimum blood glucose level between 2 and 4 a.m. normalized to 87 mg/dL.
CONCLUSIONS: Continuous glucose monitoring can detect nocturnal hypoglycemia in patients with primary adrenal insufficiency and hence prevent in these patients an impaired quality of life and even serious adverse effects.
Authors:
Gesine Meyer; Annika Hackemann; Juergen Reusch; Klaus Badenhoop
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2012-01-13
Journal Detail:
Title:  Diabetes technology & therapeutics     Volume:  14     ISSN:  1557-8593     ISO Abbreviation:  Diabetes Technol. Ther.     Publication Date:  2012 May 
Date Detail:
Created Date:  2012-05-02     Completed Date:  2012-09-04     Revised Date:  2013-06-26    
Medline Journal Info:
Nlm Unique ID:  100889084     Medline TA:  Diabetes Technol Ther     Country:  United States    
Other Details:
Languages:  eng     Pagination:  386-8     Citation Subset:  IM    
Affiliation:
Department of Endocrinology and Diabetes, University Hospital, Frankfurt, Germany. gesine.meyer@kgu.de
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MeSH Terms
Descriptor/Qualifier:
Addison Disease / blood,  complications,  diagnosis*,  drug therapy
Adult
Aged
Blood Glucose / metabolism*
Blood Glucose Self-Monitoring / methods*
Circadian Rhythm*
Female
Humans
Hydrocortisone / administration & dosage*
Hypoglycemia / blood,  diagnosis*,  etiology,  prevention & control
Male
Middle Aged
Monitoring, Ambulatory
Monitoring, Physiologic / methods
Patient Compliance
Patient Education as Topic
Retrospective Studies
Young Adult
Chemical
Reg. No./Substance:
0/Blood Glucose; 50-23-7/Hydrocortisone
Comments/Corrections

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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