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The altered circadian pattern of basal insulin requirements – an early marker of autoimmune polyendocrine syndromes in type 1 diabetes mellitus

In: ENDOCRINE REGULATIONS, vol. 54, no. 2
M. Pallayova - D. Breznoscakova

Details:

Year, pages: 2020, 126 - 132
Language: eng
Keywords:
type 1 diabetes mellitus, hypoglycemia, autoimmune polyendocrine syndromes, insulin, hypothyroidism, Addison disease
Article type: Research Article
Document type: Research Article
About article:
Objectives. The purpose of the present paper is to propose and introduce novel biomarkers of autoimmune polyendocrine syndromes that are relevant to the early diagnosis and optimal medical management of the patients who already suffer from type 1 diabetes mellitus. Methods. We hypothesize and demonstrate on a case study that various organ-specific autoimmune endocrinopathies can result in lowered basal insulin requirements, leading to unexplained hypoglycemia. Results. It can be hypothesized that hypothyroidism in patients with type 1 diabetes mellitus may deteriorate glycemic control and can lead to an increased rate of hypoglycemia, particularly the overnight and morning hypoglycemia. Thus, the decreased requirements for particularly overnight basal insulin can be an early marker of the autoimmune polyendocrine syndrome-3 with subclinical autoimmune thyroiditis in immune-mediated type 1 diabetes mellitus. Further, it could be proposed that unexplained hypoglycemia during the late afternoon or evening could be an early marker of the autoimmune polyendocrine syndrome-2 with subclinical autoimmune Addison disease in immune-mediated type 1 diabetes mellitus. As a result, an altered circadian pattern of basal insulin requirements can occur, characterized by a decreased late afternoon basal insulin rate. Conclusions. After exclusion of other causes, the unexplained reoccurring hypoglycemia can be a remarkable feature of autoimmune polyendocrine syndromes in immune-mediated type 1 diabetes mellitus on intensive insulin replacement therapy.
How to cite:
ISO 690:
Pallayova, M., Breznoscakova, D. 2020. The altered circadian pattern of basal insulin requirements – an early marker of autoimmune polyendocrine syndromes in type 1 diabetes mellitus. In ENDOCRINE REGULATIONS, vol. 54, no.2, pp. 126-132. 1210-0668. DOI: https://doi.org/10.2478/enr-2020-0015

APA:
Pallayova, M., Breznoscakova, D. (2020). The altered circadian pattern of basal insulin requirements – an early marker of autoimmune polyendocrine syndromes in type 1 diabetes mellitus. ENDOCRINE REGULATIONS, 54(2), 126-132. 1210-0668. DOI: https://doi.org/10.2478/enr-2020-0015
About edition:
Publisher: Sciendo
Published: 8. 5. 2020