Diabetes Self-healing Is Not Necessarily A Good Thing

Case:

Ms. Zhang is a company manager, found diabetes in the hospital two years ago, has since followed up in the hospital. Because of her very busy, very difficult to adhere to regular medication, blood glucose control have been less than ideal. Not long ago she came to the referral, said she was nearly two months, polydipsia, polyuria, polyphagia and other symptoms disappeared, after taking the often hypoglycemia, try a few times after stopping at home self-test blood sugar is not high , asked the doctor is not completely cured of diabetes. She recently asked whether there where trouble? She said: "The main feeling of the whole body boring, old want to sleep, loss of libido, especially in cold, lower extremity edema." The doctor told her: "diabetes symptoms suddenly disappeared for no reason, is not necessarily a good thing, best to do some checking and endocrine aspects of pituitary MRI. "

Inspection results made by doctors, unfortunately, she was a "pituitary tumor with concomitant anterior pituitary dysfunction."

Read the solution

The human pituitary gland is a nexus of important endocrine organ, according to the tissue sources were divided into before and after the two leaves, before the leaves secrete adrenocorticotropic hormone, thyroid stimulating hormone, growth hormone glucagon, these hormones act on the adrenal gland, target organs such as thyroid, adrenal cortex hormones make the body and increase thyroid hormone secretion, led directly to the blood sugar; growth hormone but also by inhibiting the production of anti-glucokinase and insulin, so blood sugar. When pituitary tumors, the first leaf tissue damage, endocrine dysfunction, and ultimately lead to adrenal cortex hormones, thyroid hormone and growth hormone secretion, blood glucose levels drop. At this point, the symptoms of diabetes can be followed to reduce or even disappear.

Anterior pituitary dysfunction causes include: ① the most common pituitary tumors, such as chromophobe adenoma. ② neurosurgery, trauma, removal or injury of the pituitary. ③ radiation therapy, damage to the pituitary. ④ invasion or infectious diseases such as leukemia, tuberculosis and other invasive pituitary damage. ⑤ Others, such as pituitary inflammation and bleeding of women in childbirth. Above causes can lead to pituitary insufficiency caused by the disease.

Anterior pituitary dysfunction in patients sensitive to insulin, blood sugar dropped prone and unstable, even with severe low blood sugar. Can also occur on cold chills, dry hair, loss of appetite, loss of libido, irregular menstruation, or amenorrhea, low blood pressure and other adrenal function, thyroid function and a range of symptoms of hypogonadism.

Clinically, in addition to pituitary tumors with active treatment, patients may be appropriate to supplement prednisone, thyroxine, and gonadal hormone replacement therapy carried out in the application of hypoglycemic drugs should be careful to avoid using insulin, and to strengthen the monitoring of blood glucose. If a patient is hypoglycemia or adrenal hypofunction crisis, the input of glucose at the same time, should be noted that additional glucocorticoid and sodium.

Chronic adrenal cortex hypofunction: a variety of reasons to reduce the secretion of adrenal hormones or even disappear. Including secondary to anterior pituitary dysfunction, resulting in the secretion of hormone deficiencies.
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Features: The patient showed weakness, low blood pressure, tend to have low blood sugar, skin pigmentation, loss of sodium, weight loss, anorexia and gastrointestinal symptoms. Stress can be acute adrenal crisis.

Adrenal crisis: When the patients with infection, trauma, surgery, childbirth, excessive fatigue, profuse sweating or cortisol treatment interruption, can be induced crisis, high fever, nausea, vomiting, diarrhea, dehydration, irritability, severe when the blood pressure, pulse, thin, attenuated peripheral circulation, leading to shock and coma. Some patients with low blood sugar as the main performance.