PDF(Pubmed)
Abstract：
OBJECTIVE: Adrenal insufficiency (AI) is a hormonal disorder characterized by insufficient glucocorticoid production. Nocturnal hypoglycemia (NH) occurs in patients with AI. However, the effect of glucocorticoid replacement therapy (GCRT) on AI and NH remains unclear. This study aimed to investigate the relationship between AI and NH by evaluating the impact of GCRT on NH in patients newly diagnosed with AI.
METHODS: The present study was conducted between October 2018 and December 2022 at the Department of Diabetes, Metabolism and Endocrinology of the Tokyo Rosai Hospital, Japan. In total, 15 patients aged ≥18 years with newly diagnosed AI or NH were included in this study. The NH frequency was measured using continuous glucose monitoring (CGM). The primary outcome was the change in NH frequency before and after the GCRT intervention.
RESULTS: GCRT significantly decreased NH frequency. Severe NH frequency and minimum nocturnal glucose levels changed significantly while fasting blood glucose and glycated hemoglobin levels did not change significantly. GCRT intervention improved CGM profiles\' time below range, time in range, and average daily risk range.
CONCLUSIONS: The present study suggests that GCRT can help newly diagnosed patients with AI manage NH. These findings show that CGM can detect NH in patients with newly diagnosed AI, determine the optimal GCRT dosage, and hence prevent an impaired quality of life and even serious adverse effects in these patients. Further large multicenter studies should validate these findings and delve deeper into the mechanistic link between AI and NH.
METHODS: The present study was conducted between October 2018 and December 2022 at the Department of Diabetes, Metabolism and Endocrinology of the Tokyo Rosai Hospital, Japan. In total, 15 patients aged ≥18 years with newly diagnosed AI or NH were included in this study. The NH frequency was measured using continuous glucose monitoring (CGM). The primary outcome was the change in NH frequency before and after the GCRT intervention.
RESULTS: GCRT significantly decreased NH frequency. Severe NH frequency and minimum nocturnal glucose levels changed significantly while fasting blood glucose and glycated hemoglobin levels did not change significantly. GCRT intervention improved CGM profiles\' time below range, time in range, and average daily risk range.
CONCLUSIONS: The present study suggests that GCRT can help newly diagnosed patients with AI manage NH. These findings show that CGM can detect NH in patients with newly diagnosed AI, determine the optimal GCRT dosage, and hence prevent an impaired quality of life and even serious adverse effects in these patients. Further large multicenter studies should validate these findings and delve deeper into the mechanistic link between AI and NH.
摘要：
目的：肾上腺功能不全（AI）是一种激素紊乱，其特征是糖皮质激素产生不足。AI患者会发生夜间低血糖（NH）。然而,糖皮质激素替代疗法(GCRT)对AI和NH的影响尚不清楚.本研究旨在通过评估GCRT对初诊AI患者NH的影响来探讨AI与NH的关系。
方法：本研究于2018年10月至2022年12月在糖尿病科进行。东京罗塞医院的代谢和内分泌学，日本。总的来说,本研究纳入了15例年龄≥18岁的新诊断AI或NH患者。使用连续葡萄糖监测(CGM)测量NH频率。主要结果是GCRT干预前后NH频率的变化。
结果：GCRT显著降低NH频率。严重的NH频率和最低夜间血糖水平显着变化，而空腹血糖和糖化血红蛋白水平没有显着变化。GCRT干预改善了CGM配置文件的时间低于范围，范围内的时间，和平均每日风险范围。
结论：本研究提示GCRT可以帮助新诊断的AI患者控制NH。这些发现表明，CGM可以在新诊断的AI患者中检测到NH，确定最佳GCRT剂量，并因此防止这些患者的生活质量受损，甚至严重的不良反应。进一步的大型多中心研究应该验证这些发现，并更深入地研究AI和NH之间的机制联系。
方法：本研究于2018年10月至2022年12月在糖尿病科进行。东京罗塞医院的代谢和内分泌学，日本。总的来说,本研究纳入了15例年龄≥18岁的新诊断AI或NH患者。使用连续葡萄糖监测(CGM)测量NH频率。主要结果是GCRT干预前后NH频率的变化。
结果：GCRT显著降低NH频率。严重的NH频率和最低夜间血糖水平显着变化，而空腹血糖和糖化血红蛋白水平没有显着变化。GCRT干预改善了CGM配置文件的时间低于范围，范围内的时间，和平均每日风险范围。
结论：本研究提示GCRT可以帮助新诊断的AI患者控制NH。这些发现表明，CGM可以在新诊断的AI患者中检测到NH，确定最佳GCRT剂量，并因此防止这些患者的生活质量受损，甚至严重的不良反应。进一步的大型多中心研究应该验证这些发现，并更深入地研究AI和NH之间的机制联系。
