{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,14]],"date-time":"2025-05-14T00:51:30Z","timestamp":1747183890189,"version":"3.40.5"},"reference-count":22,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2020,6,9]],"date-time":"2020-06-09T00:00:00Z","timestamp":1591660800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Endocrinology"],"published-print":{"date-parts":[[2020,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Patients with Addison's disease (AD) and comorbid type 1 diabetes mellitus (T1DM) are at increased risk of certain acute metabolic disorders relative to patients with one of these conditions only. The reasons for this are unknown.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>All attendances for acute illness by AD patients at the emergency department of a Sydney hospital between 2000 and 2017 were reviewed. Physiological parameters and illness management strategies were compared between AD patients, those with T1DM and AD combined, and a control group of patients with T1DM.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>There were 39 presentations for an acute medical illness by 20 nondiabetic AD (28 attendances) and 5 diabetic AD patients (11 presentations) and 40 attendances by 10 T1DM controls. In AD patients, 17 (43.6%) attendances were medically diagnosed adrenal crises (AC) (63.6% [n\u00a0=\u00a07] in diabetic AD and 35.7% [n\u00a0=\u00a010] in nondiabetic AD). This corresponded to an estimated incidence of 12.5 AC\/100 patient\u2010years (PY) for diabetic AD patients compared to 4.7 AC\/100PY for nondiabetic AD patients (<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a0.05). Glucocorticoid stress doses preceded 61.5% (n\u00a0=\u00a024) of all attendances. Patients who used stress doses had more presentations than those who did not (2.0\u00a0\u00b1\u00a01.3 vs 1.2\u00a0\u00b1\u00a00.5, <jats:italic>P<\/jats:italic>\u00a0=\u00a0.01). Diabetic AD patients had a lower mean blood glucose level on presentation (5.6\u00a0\u00b1\u00a03.9\u00a0mmol\/L) than the T1DM control sample (11.6\u00a0\u00b1\u00a06.2\u00a0mmol\/L) <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a0.001. No T1DM patients had hypoglycaemia in the 3.0\u20103.9\u00a0mmol\/L range but 2 (18.2%) of the diabetic AD patients had presenting blood glucose levels in this category (<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a0.05). Hyperglycaemia was more common among T1DM control patients (62.5%, n\u00a0=\u00a026) than diabetic AD patients (18.2%, n\u00a0=\u00a02), <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a0.01.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Addison's disease patients with T1DM have a higher incidence of adrenal crisis (AC) and hypoglycaemia than nondiabetic AD patients and a lower incidence of hyperglycaemia than those with T1DM alone. This information may be of value in counselling patients with T1DM and AD about AC and hypoglycaemia prevention.<\/jats:p><\/jats:sec>","DOI":"10.1111\/cen.14219","type":"journal-article","created":{"date-parts":[[2020,5,12]],"date-time":"2020-05-12T21:30:37Z","timestamp":1589319037000},"page":"104-110","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Acute illness in patients with concomitant Addison's disease and type 1 diabetes mellitus: Increased incidence of hypoglycaemia and adrenal crises"],"prefix":"10.1111","volume":"93","author":[{"given":"Brienna","family":"Mortimer","sequence":"first","affiliation":[{"name":"School of Medicine, Sydney The University of Notre Dame Sydney NSW Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vaidehi Dhirendra","family":"Naganur","sequence":"additional","affiliation":[{"name":"School of Medicine, Sydney The University of Notre Dame Sydney NSW Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6546-1233","authenticated-orcid":false,"given":"Paul","family":"Satouris","sequence":"additional","affiliation":[{"name":"School of Medicine, Sydney The University of Notre Dame Sydney NSW Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jerry R.","family":"Greenfield","sequence":"additional","affiliation":[{"name":"Department of Endocrinology Darlinghurst and St Vincent's Clinical School St Vincent's Hospital University of NSW Sydney NSW Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David J.","family":"Torpy","sequence":"additional","affiliation":[{"name":"Endocrine and Metabolic Unit Royal Adelaide Hospital and University of Adelaide Adelaide SA Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6270-747X","authenticated-orcid":false,"given":"Rosemary Louise","family":"Rushworth","sequence":"additional","affiliation":[{"name":"School of Medicine, Sydney The University of Notre Dame Sydney NSW Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2020,6,9]]},"reference":[{"issue":"2","key":"e_1_2_7_2_1","first-page":"165","article-title":"An update on Addison's disease","volume":"127","author":"Barthel A","year":"2019","journal-title":"Exp Clin Endocrinol Diabetes"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2015-1710"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1530\/EJE-08-0550"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2006-0076"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2265.2008.03340.x"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12020-016-1204-2"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra1807486"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2014-3191"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/cen.13985"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/cen.13043"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2265.2002.t01-1-01552.x"},{"volume-title":"International Statistical Classification of Diseases and Related Health Problems, 10th Revision, Australian Modification (ICD\u201010\u2010AM), Australian Classification of Health Interventions (ACHI), Australian Coding Standards (ACS), National Centre for Classification in Health","year":"2006","author":"National Centre for Classification in Health","key":"e_1_2_7_13_1"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9343(77)90233-9"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2007-0445"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1530\/EJE-08-1003"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0035-1548869"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0034-1395680"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2011-1926"},{"key":"e_1_2_7_20_1","doi-asserted-by":"publisher","DOI":"10.1530\/EJE-09-0170"},{"key":"e_1_2_7_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2213-8587(17)30398-4"},{"key":"e_1_2_7_22_1","doi-asserted-by":"publisher","DOI":"10.1210\/js.2019-00263"},{"key":"e_1_2_7_23_1","doi-asserted-by":"publisher","DOI":"10.1111\/cen.13826"}],"container-title":["Clinical Endocrinology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/cen.14219","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/cen.14219","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/cen.14219","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,5]],"date-time":"2023-09-05T05:36:52Z","timestamp":1693892212000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/cen.14219"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,6,9]]},"references-count":22,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2020,8]]}},"alternative-id":["10.1111\/cen.14219"],"URL":"https:\/\/doi.org\/10.1111\/cen.14219","archive":["Portico"],"relation":{},"ISSN":["0300-0664","1365-2265"],"issn-type":[{"type":"print","value":"0300-0664"},{"type":"electronic","value":"1365-2265"}],"subject":[],"published":{"date-parts":[[2020,6,9]]},"assertion":[{"value":"2020-01-13","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-04-22","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-06-09","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}