Addisons Disease and Diabetes

[Frostypants]

Hello, I have just joined and been doing lots of reading. My mind is over flowing and it has been a tough week. Maybe someone can help make sense. My daughter 18 has been on hydrocortisone now for about 5 years for her addisons, she also has daily growth hormone injections for about the same amount of time. After prolonged illness on and off I took her to the gp for bloods. All normal except sugars 14.3. Asked to return for urine and finger prick. Plus plus plus ketones and glucose and sugars 15.4. Referred to hospital. After some fluids discharged with ketones in blood normal range and raises sugars to monitor. That night she went up to 23.8 sk back to hospital again admitted. Suspected T1 or steroid induced. She started on gliclazide 1 tablet. Still high blood from 12 to 23. Increased next day to 2 tablets bg similar, next day 3 tablets still the same so 4 days later prescribed lanctus 5 units. Bg on waking 8, before lunch 15. Her HbA1c was 53 and waiting kn other bloods. Not really sure what my question is its just all so confusing and no idea what is going to come back.......she is extremely petit build and lost 6lbs in a week.

 

[Paulbreen]

Hello and welcome, sounds like you have your hands full, I just wanted to share I had a lot of trouble in the past with steroids, I’m T1 too, against my better judgement I took Cortisone 4 weeks ago and it devastated my usual BG control, I lasted 2 days before I had to stop them.
Im sure you will get some great advice and help here, there’s a wealth of knowledge and experience to tap into

 

[Frostypants]

Thank you Paulbreen. Im hoping so its been a real roller coaster of emotions and my poor daughter is really struggling not really knowing whats going to happen next. I'm glad you were able to stop them and get your bg back under control. Can I ask how you find managing it?

 

[Inka]

Suspected T1 or steroid induced. She started on gliclazide 1 tablet. Still high blood from 12 to 23. Increased next day to 2 tablets bg similar, next day 3 tablets still the same so 4 days later prescribed lanctus 5 units. Bg on waking 8, before lunch 15. Her HbA1c was 53 and waiting kn other bloods. Not really sure what my question is its just all so confusing and no idea what is going to come back.......she is extremely petit build and lost 6lbs in a week.

Are the other bloods you’re waiting for ones to check for Type 1? I hope so, as even if it’s not that it’s good to rule out so you have some certainty.

The Lantus is a basal/background insulin. If necessary, there are bolus/fast-acting insulins that can help deal with the food your daughter eats. That would help keep her sugars down and allow her to eat what she needs.

 

[Frostypants]

Hi Inka I believe so. There seems to be alot of confusion amongst the different teams. She is due a 24hr profile for her hydrocortisone too dec 15th. From what I can understand some think type 1 but need to wait on bloods but endocrine think steroid induced? Not sure how that affects the different treatments or again if this is something lifelong? Can it be reversed? I also wonder if her age is an added thought for the teams?? All I can say from what I see is she just not right and as a parent I'm super proud of her but also so worried

 

[Frostypants]

Can I ask also hydrocortisone affects bg is that the same even though its her maintenance dose as to speak? I think I'm over thinking things

 

[Inka]

As I understand it, steroid-induced diabetes can go away but doesn’t always. As you can imagine, it depends on many variables.

Type 1 is an auto-immune condition and can’t be cured at the moment, but can be controlled with insulin.

 

[Inka]

Can I ask also hydrocortisone affects bg is that the same even though its her maintenance dose as to speak? I think I'm over thinking things

I don’t know as I haven’t had to take steroids, but I would presume any blood sugar effect would continue. I’m not sure though. Diabetes U.K. has a basic info page:

https://www.diabetes.org.uk/diabetes-the-basics/other-types-of-diabetes/steroid-induced-diabetes

.

 

[Paulbreen]

Hi Frostypants, I love the name by the way,
Best advice is to try and take it all in slowly, there is so much with this disease that will stress you and your daughter, but you have found a great place to ask questions and vent if and when the need takes you. In my recent escapade I got tinnitus and my ear doctor prescribed the cortisone as the standard fix so like I said I had a go with them more than half expecting the BG issues because of a previous adventure with steroids, I just stopped the pills and it took a day to get my bloods back to normal, I’m a CGM and pump user so I had to do some additional injections with a pen to avoid messing up the settings in my pump, after that it was all fine.
Im 47 years with T1 so I have some experience so to speak and should have known better than let a doctor tell me to take the steroids.
I can say over the years of this disease I’ve had my ups and downs, I’ve only be in hospital once with a complication, Acetone keytosis after too much partying in my younger days but on the whole I’ve survived marginally ok. I find just being positive helps me through most of the stuff life throws at us, I wish I could bottle it because I have friends who suffer from other illnesses and they struggle to be positive and I can’t explain it to them
I wish you both all the best with your journey and please don’t hesitate to shout when you need it

Thank you Paulbreen. Im hoping so its been a real roller coaster of emotions and my poor daughter is really struggling not really knowing whats going to happen next. I'm glad you were able to stop them and get your bg back under control. Can I ask how you find managing it

 

[grovesy]

I believe @Pumper_Sue has Type 1 and Addison's disease.

 

[Pumper_Sue]

I believe @Pumper_Sue has Type 1 and Addison's disease.

Your belief is correct 🙂

 

[Pumper_Sue]

Can I ask also hydrocortisone affects bg is that the same even though its her maintenance dose as to speak? I think I'm over thinking things

Hello @Frostypants (love the name)
I would suspect your daughter has type 1 diabetes due to Addison's being autoimmune.
Sounds as if the Lantus did it's job overnight to achieve the 8 in the morning.
The 15 before lunch is due to the wallop from the steroid dose hitting home.
I need very little insulin during the night but from 8am until 11am I have to ramp up my dosage because about lunchtime that's when the steroid dose hits home, same for 1.30pm until 4pm I need extra insulin compared to my normal hourly rate to coincide with when the steroids hit the mark.
Insist your daughter has a pump (that's if she wants one) as control of both conditions is so much easier.
Ask as many questions as you need and I will try and help if I can.

 

[Frostypants]

Thank you all. I suppose they will monitor her for a bit now whilst we wait for gad results and to see how her body acts with the lantus. But what you have said Pumper_Sue describes her perfectly

 

[everydayupsanddowns]

Thank you all. I suppose they will monitor her for a bit now whilst we wait for gad results and to see how her body acts with the lantus. But what you have said Pumper_Sue describes her perfectly

Everything crossed for you both @Frostypants - hope you get some clarity over the diagnosis really soon and that the meds begin to take those BG levels back down smoothly 🙂

 

[Frostypants]

Thank you everydayupsanddowns. We have just had a call to introduce novorapid at lunch and dinner. No clarity in diagnoses yet but they said either way they are currently treating her as T1. I think today it has hit home for her. She is very emotional and struggling

 

[rebrascora]

I think today it has hit home for her. She is very emotional and struggling

If it is any consolation that is a common reaction, even for an old fogey like me. I got teary when I was told that I would be started on insulin 6 weeks after my initial diagnosis and I realised that I wasn't going to be able to reverse my diabetes no matter how strict I was with my diet and this was for life now. It is very much like grieving. However, I am now in a much happier and healthier place than I was 21 months ago. Yes, trying to manage BG levels on a daily basis is frustrating but I have made a concerted effort to improve my diet and fitness and I am in the best shape I have been for maybe 30 years and at 56 that feels good physically and mentally and I would not be in this situation if it hadn't been for my diabetes diagnosis, so there have been positives to come out of it. Focusing on those helps to motivate me to keep doing what I am doing and keeping myself healthy.

 

[Inka]

The Novorapid will enable her to eat while keeping better control of her blood sugar. That’s a positive thing. As her blood sugar comes down she should also feel physically better.

It’s perfectly natural to be upset - it’s a big shock. Please tell her she’s not alone. It’s frustrating that you’re still having to wait for a definite diagnosis. That can’t help.

 

[Frostypants]

Aw Thanks again .....I will tell her and try to reassure her. Im hopefull that once she becomes a bit more stable she can go back to doing what she enjoys, working in a nursery and doing her level 3. Rebrascora thank.you for being so open and honest. You have clearly come a long way and I'm so pleased to read mentally as well as physically you are in a better place. Time can be a great thing.

 

[trophywench]

I'm 100% with @Inka here - it is natural. Even the NHS (thank God for them) tells all and sundry these days that being diagnosed with anything chronic (in the true meaning of the word - ie lifelong and incurable) is emotionally so similar to an actual loss of someone close to you's life, that it always takes time to get used to it and that some folk seem to manage OK with such a thing and others take longer.