January 30, 2005
Other
Question from York, Pennsylvania, USA:
My daughter, age 25, has had type 1 diabetes for almost two years. For the past six months, she has had extreme fatigue, to the point that she has taken a six week leave of absence from her job thinking it may be job related stress. It must not be stress related because since being off a month, she still requires about 10 hours or more of sleep per day. Her doctor has done blood work and has ruled out low thyroid, anemia, lyme disease, etc. A therapist and her family doctor have ruled out depression. She is doing carbohydrate counting, following the mediterranean diet, and exercising every day. She has had problems with low blood pressure in the past and had a few episodes of syncope about five years ago when going from a sitting to a standing position. She hasn’t had any episodes for four years, however, but her blood pressure and pulse remain low. Can low blood pressure cause fatigue? What else should we consider?
Answer:
Adrenal insufficiency can occasionally occur in people who have type 1 diabetes. Since both are autoimmune diseases, meaning that the immune system works to damage irreversibly the organ that makes the hormone, they may occur together. Adrenal insufficiency is associated with a sudden onset form or a more chronic form. The chronic form is associated with increased pigmentation, fatigue, dizziness with standing or sitting up, nausea, occasional vomiting, and responds very well to hormone replacement. You may want to talk with her physician about this and see whether it has been looked at.
JTL
