Simůnková Katerina, Vondra Karel
Endokrinologický ustav, Praha.
Cas Lek Cesk. 2010;149(3):120-4.
Adrenocortical disorders represents an important problem in patients with type 1 diabetes mellitus and therefore many physicians are concerned with this issue. The causes of adrenocortical insufficiency include both autoimmunity and dysregulation related to insufficiently compensated diabetes. Early diagnosis of hypocorticism remains doubtful. Diagnostic approaches are not standardized or unified and especially their evaluation and interpretation are a matter of discussion. Treatment of proven hypocorticism, notably of the subclinical form in diabetic patients, remains questionable. Modes of substitution used presently cannot mimic fully diurnal rhythm of glucocorticoid secretion in spite of newly developed drug forms. The risk of glucocorticoid overdose persists, and insulinotherapy need to be adjusted permanently.
肾上腺皮质疾病是1型糖尿病患者的一个重要问题，因此许多医生都关注这个问题。肾上腺皮质功能不全的病因包括自身免疫和与糖尿病补偿不足相关的调节异常。肾上腺皮质功能减退的早期诊断仍存在疑问。诊断方法尚未标准化或统一，尤其是其评估和解读仍存在争议。已证实的肾上腺皮质功能减退的治疗，尤其是糖尿病患者的亚临床形式，仍存在疑问。尽管有新开发的药物剂型，但目前使用的替代模式仍无法完全模拟糖皮质激素分泌的昼夜节律。糖皮质激素过量的风险仍然存在，胰岛素治疗需要不断调整。
