Mortality in patients with diabetes mellitus and Addison’s disease: a nationwide, matched, observational cohort study

Abstract

Patients with the rare combination of diabetes and AD showed a markedly increased mortality and died more frequently from infections and unknown causes than patients with diabetes alone. Improved strategy for the management of this combination of metabolic disorders is needed.

Incidence, prevalence and seasonal onset variation of Addison’s disease among persons with type 1 diabetes mellitus: nationwide, matched cohort studies

“…Persons with endogenous Cushing's syndrome and/or any disorders of the pituitary gland were excluded. Details on all ICD-9 and ICD-10 codes used in this study are presented in previous article by our group (16). For T1DM, we used the clinical classification which is the diagnosis attributed to the persons by the physicians who reported them to the NDR.…”

“…Previous studies have shown an increased risk of adrenal crises among persons with both T1DM and AD (16,26,27,28). Adrenal crisis is potentially lifethreatening if not discovered and treated in a timely manner.…”

“…Having both T1DM and AD is rare (10,15), and we have recently shown that this combination of endocrine metabolic diseases is associated with an excess mortality that markedly exceeds the mortality for T1DM and AD per se (16). Between 10.7% and 12% of persons with AD also have T1DM (10,17) and the estimated prevalence of the combination in Western Norway was 20 per million persons in the population (9), whereas in a US population of persons with T1DM, it was found to be 2912 per million (2).…”

Increased mortality and morbidity in patients with chronic hypoparathyroidism: A population‐based study

“…In addition, some of the non‐surgical cases are likely to be due to genetic mutations, for example, DiGeorge syndrome, which are known to be associated with congenital heart defects and urogenital abnormalities . Other autoimmune aetiologies, for example, autoimmune polyglandular syndrome, are associated with Addison's disease and thyroid disease potentially placing patients at risk . Conventionally, the aim of treatment has been to maintain the serum calcium concentration around the lower limit of the reference range.…”

“…13 Other autoimmune aetiologies, for example, autoimmune polyglandular syndrome, are associated with Addison's disease and thyroid disease potentially placing patients at risk. 14,15 Conventionally, the aim of treatment has been to maintain the serum calcium concentration around the lower limit of the reference range. This limits the risks of hypercalciuria and hypercalcaemia with the resultant risks of symptoms, renal stones and other complications.…”