What part do adrenal glands and cortisol levels have on type 1? My child’s numbers are so erratic that I was wondering if I am missing something else. Could there be an adrenal problem also, and, if so, how are adrenal tests done?

Excess cortisone production is rather rare in childhood and adolescence and not associated at all with diabetes, except if someone were getting large doses of therapeutic cortisone for other illnesses (i.e,. cancer, asthma, arthritis, etc. ).

Low cortisone production can be associated with type 1 diabetes as one of several autoimmune disorders – like Hashimoto’s thyroiditis and celiac disease clearly increased because of shared genetic factors. Adrenal insufficiency usually presents with unexplained hypoglycemia and not with lability. It is easiest to measure blood cortisol levels first thing in morning with concomitant ACTH levels to indicate if the adrenal gland output and the pituitary output are normal and in sync with one another. Adrenal antibodies can also be measured in a blood sample; if positive, then this is adrenalitis, one type of Addison’s disease. If still a puzzle, ACTH stimulation tests can be done to test if the adrenal gland response is normal or not.

SB