COEXISTENCE OF ADDISON'S DISEASE AND DIABETES MELLITUS: REPORT OF THREE CASES WITH A DISCUSSION OF METABOLIC INTERRELATIONSHIPS

Abstract

Three cases of co-existing diabetes mellitus and Addison's disease are reported. In 2, diabetes developed after adrenal insufficiency had existed for years. Only 15 cases with this sequence of onset of the 2 diseases have been reported previously. The effect of each disease upon the pathophysiology and course of the other is discussed. The usual sequence of onset is diabetes mellitus complicated later by adrenal insufficiency. In such instances there occurs a melioration of the diabetic state, followed by progressive deterioration of the patient unless appropriate treatment is given for adrenal insufficiency. With such treatment the diabetes returns to its former degree of intensity, but stabilization is facilitated. When Addison's disease is complicated secondarily by diabetes mellitus, there may be intensification of the adrenal insufficiency which can be corrected only partially by larger doses of salt-active steroids. After appropriate therapy for the diabetes has been instituted, the steroid requirement returns to its former level. A brief survey is included of diseases other than those involving the adrenal cortex, which tend to ameliorate the diabetic state.