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July 30, 2001

Research: Causes and Prevention

Question from Houston, Texas, USA:

My 36 year old wife suffered a severe concussion in an automobile accident about nine months ago, and within three weeks of the injury she developed very high glucose levels and was diagnosed with diabetes mellitus. She had no prior history, her pancreas appears to produce normal levels of insulin, and she is attempting to control glucose levels with oral hypoglycemic agents. At the same time, her thyroid activity decreased and she is taking medication to offset the decreased activity. Could the diabetes and thyroid problem be related? Could the concussion have caused this by injury to the brain? Could the adrenal system or pituitary system be involved which should be treated directly also?

Answer:

One of the most common things which comes to mind is the use of glucocorticoids, also known as steroids, to decrease brain edema or swelling. When these agents are used in high doses, they induce diabetes in individuals with a susceptible family history.

I would also caution you that interpretation of thyroid function in acute illness is difficult. If there is clear hypothyroid, I would also recommend you speak to your physician about evaluation of pituitary function. The pituitary gland is the master endocrine organ and sits in the brain. If damage occurs to the pituitary, you can have low hormone production by a variety of hormone organs.

JTL